Epilepsy-Related Cognitive Impairment

Epilepsy is a neurological condition in which abnormal electrical activity in the brain causes recurrent seizures. Some seizures are obvious, like when a person passes out and has shaking of their entire body (generalized tonic clonic seizures, also known as grand mal seizures). Other seizures are much less obvious, and may only manifest as a pause in speech and physical activity with staring noted (either complex focal seizures or generalized absence seizures also known as petit mal seizures).

Epilepsy can be caused by other neurological conditions, like a stroke, brain tumor, brain infection (such as meningitis or encephalitis), traumatic brain injury, or autoimmune brain disease. Some genetic conditions and metabolic disorders can also lead to epilepsy. Epilepsy can also be caused by dementia. Sometimes though doctors cannot find any particular cause for a person’s epilepsy.

Cognitive difficulties are common in people with epilepsy, especially in people whose seizures are frequent, prolonged (as in status epilepticus), or begin in the temporal lobe (temporal lobe epilepsy).

An EEG (electroencephalogram) is a non-invasive procedure that can check the brain’s electrical activity. People with epilepsy who have excessive activity on EEG when they are not having a seizure (known as interictal epileptiform discharges or interictal spikes) have worse cognitive performance. The medications used to treat seizures (antiepileptics), however, can also contribute to cognitive side effects. Mood disorders like depression and anxiety, which are associated with epilepsy, can also affect cognitive function.

When a person has memory problems, it is important to have a comprehensive evaluation to make sure that the cause is not due to undiagnosed epilepsy, undertreated epilepsy, antiepileptic medication side effects, undiagnosed or undertreated mood disorders, or a combination of these factors.

References and Resources

  1. https://www.epilepsy.com/what-is-epilepsy
  2. https://www.cdc.gov/epilepsy/about/types-of-seizures.htm
  3. Holmes, GL. (2015). Cognitive impairment in epilepsy: the role of network abnormalities. Epileptic Disord, 17(2), 101-116. doi:10.1684/epd.2015.0739

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