William Barr, Ph.D., ABPP
NYU Comprehensive Epilepsy Center
New York, NY

What causes memory problems in people with epilepsy? The answer is not so simple. Most experts agree that a number of factors, in combination, are the likely cause. Psychologists Bruce P. Hermann and Steven Whitman have outlined a scheme to explain a wide range of behavioral phenomena associated with epilepsy. Their hypothesis is that epilepsy exerts three major influences:

1. Neurobiological influences, including direct effects of abnormal brain function and of seizures
2. A treatment effect, including the impact of antiepileptic medication on thinking and behavior
3. The effect of psychosocial factors, including how mood and self-esteem may contribute to your perceived quality of life

Each of these factors must be considered when examining the possible causes of your memory difficulty.

What about my age?

When discussing the issue of memory disturbance, it must be made clear that memory problems are clearly a function of age. It is normal for people to develop less efficient memory functions in their later years. The process actually starts in the late thirties, with a very subtle decline into the fifties. Changes begin to occur around the age of 55. Some people remain relatively healthy and just continue the subtle decline. In others, the decline becomes more accelerated. It is difficult to predict who is at risk for developing what doctors now call "mild cognitive impairment" (MCI) associated with aging. It is also unclear how many people with MCI will later develop Alzheimer's disease. Genetic factors play a significant role. Health-related factors are also very important.

Memory disorders do not happen naturally in a younger person. If you are having memory problems and are under 50, you should consult your doctor about possible causes. The neurobiological effects of an underlying physical disorder need to be ruled out. In the general population, neurobiological causes affect only a minority of patients. In younger people with epilepsy, however, neurobiological effects are common causes of memory problems, although they are not the only causes to consider.