For now, I am going to continue talking about epilepsy. However, this time you all get to hear about one of the lovely side effects that comes with having seizures, as well as the current treatments for them, specifically medications. I will be focusing on memory because it is the one of the most difficult cognitive issue that I deal with on a daily basis. As I was doing my research, I noticed that no one seemed to be concerned with which process of long-term memory was being effected. However, at least there are finally therapies for the cognitive issues related to epilepsy.
A study conducted by Witt and Heimstaedter in 2012, found that 47.8% of their subjects experienced memory deficits. Other studies have shown that “greater impairments on testing correlate with… longer duration of the seizure disorder, earlier age of onset, greater seizure frequency…” ( Leeman-Markowski & Schachter, 2016, p.184). Leeman-Markowski and Schachter also mention that patients who have TLE (Temporal Lobe Epilepsy) are prone to having memory loss, sometimes verbal and sometimes general memory issues. The medications used to attempt to control seizures also can cause cognitive side effects.
The older antiepileptic drugs (AEDs) are said to have a higher risk of causing problems with “response inhibition, verbal fluency, attention and vigilance, psychomotor speed,… and memory, as well as subjective confusion and memory loss” (Leeman-Markowski & Schachter, 2016, p.186). One of the newer AEDs that I am on and am experiencing the side effects from is zonisamide. According to the article written by Leeman-Markowski and Schachter (2016), it has been found that the most common possible side effects cause “deficits in verbal intelligence, verbal learning, delayed verbal and nonverbal memory, and verbal fluency”. In other words, I am often making long pauses, or say things like “umm…”, in the middle of speaking because I lost my train of thought. Even composing this entire post has been a challenge because my ability to recall what I want to say is a challenge. There have also been many times that I have had to look up the definition of words, even ones that I have “learned” in the past, because I have no idea what they mean. Needless to say, it is extremely frustrating, not only for myself but for the people around me as well.
As far as treatments go, the first listed is to keep the pharmacological use to a minimum. In other words, try to avoid using more than one AED at a time, when possible, and keep the patient at the minimum dose of the AED(s) possible. Besides that, the most common treatment for the issues listed above is cognitive rehabilitation, which usually incorporates things like direct retaining, external compensatory strategies, and internal compensatory strategies. The issue with these types of treatment is that they may work for one deficit, but not work for others. For example, a study conducted by Engelberts, Kein, Ade et al. (2002), found that even though there was improvement in patients’ attention with the use of both direct retraining and compensatory strategies, the improvements did not apply to things that were not directly related to the training program. Treatments that are under investigation are mostly comprised of Alzheimer’s treatments, which there is not much information about right now.
While I have no idea whether the memory issues associated with epilepsy are caused by encoding or recall problems, they are none-the-less annoying. Hopefully one of these days, the cognitive issues associated with epilepsy will be a thing of the past. I am just hoping that it happens in my lifetime.
References:
Leeman-Markowski, B.A. & Schachter, S.C. (2016). Treatment of cognitive deficits in epilepsy. Neurological Clinics, 34, 183-204.
I believe that electroshock therapy, if that is what you mean, is generally more detrimental to patients in the long-term. Epileptic seizures, especially grandmals (convulsive), cause brain damage because of the electrical discharges from neurons going places that they are not meant to go. Thus, people with active epilepsy have cognitive issues. According to Breggin (2007), the results of the study conducted by Sackeim et al. (2007) show that electroshock therapy (ECT) can cause permanent cognitive issues and brain damage. He even takes note that many of Sackeim and associates’ subjects actually had abnormal EEG readings after their ECT treatment. The two memory specific deficits that are mentioned in the article are “loss of autobiographical memories” and lack of “’retention of newly learned information’” (Breggin, 2007, p.83). Findings like these make me convinced that electroshock therapy, especially electroconvulsive therapy, can cause just as many memory issues as uncontrollable electroshocks (seizures).
Reference:
Breggin, P. (2007). ECT damages the brain: Disturbing news for patients and shock doctors alike. Ethical Human Psychology and Psychiatry, 9, 83-86.
Wow! What an enthralling post! I never realized how many detrimental neurological implications epileptic seizures and their medicinal counterparts are capable of producing. To that end, being subjected to these kinds of remedial medicinal solutions, especially when considering the high potential for lifelong use indubitably increases an individual’s risk for a myriad of neurological health problems, especially with respect to memory. With all this said, I have been and still am very curious about the “brighter side” of epileptic seizures; that is to say, I have heard of an individual’s brain chemistry ultimately being reset following an acute episode of an epileptic seizure. In fact, this phenomenon has been replicated so many times with such significant results that they actually utilize the seizure per se in electroconvulsive therapy. With that said, how do you feel about this procedure, and have you looked into anything that has to do with this? I believe that delving into the mysteriousness of this concept would be extremely enlightening and rewarding. Overall, this was a well-written and well-researched blog post with a great deal of fascinating information. Nice job!