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Neurology (Expert Forum)
Long term memory loss
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Long term memory loss
by mhb, Aug 09, 2006 12:00AM
Started having seizures roughly 2½ years ago. Short falling feeling, sometimes associated with jerking to the left side; Symptoms arefatigue followed by sleepiness. Usually affect me afterwards for several days. First EEG showed a phase reversal & strange 13hz freq. On Neurontin, but recently as I approach 60 I’ve had more than usual. MRI shows a cholesterol granuloma in the left temporal apex. I suspect a tie with fluorescent lights & tiredness. At times then the world loses its third dimension. It’s hard to explain but it’s very uncomfortable.
At the same time having memory problems that started getting worse last fall. Symptoms are forgetting things & using the wrong word. At my cousins party I forgot his name, two kids names, a& my son in laws name. I literally have to go back over steps or find myself heading the wrong direction on the next step. Learning is tough: things don’t see to make it into long term memory. To learn I have to reread or relearn. I failed miserably on two word pair memorization & I’m sure the neuropsych felt I was faking it. (Particularly when the MMPI showed a conversion reaction and no depression.)
So to the questions:
• Meds help, but don't eliminate seizures. Had several seizures before a recent EEG that showed nothing abnormal (other than a whole bunch of facial tics). What could cause lack of symptoms on the latest EEG?
• Are there two things going on here or is the memory loss and associated problems related to the seizures?
• I can live if I have to with the seizures, but what’s the prognosis for memory & thought processes?
At the same time having memory problems that started getting worse last fall. Symptoms are forgetting things & using the wrong word. At my cousins party I forgot his name, two kids names, a& my son in laws name. I literally have to go back over steps or find myself heading the wrong direction on the next step. Learning is tough: things don’t see to make it into long term memory. To learn I have to reread or relearn. I failed miserably on two word pair memorization & I’m sure the neuropsych felt I was faking it. (Particularly when the MMPI showed a conversion reaction and no depression.)
So to the questions:
• Meds help, but don't eliminate seizures. Had several seizures before a recent EEG that showed nothing abnormal (other than a whole bunch of facial tics). What could cause lack of symptoms on the latest EEG?
• Are there two things going on here or is the memory loss and associated problems related to the seizures?
• I can live if I have to with the seizures, but what’s the prognosis for memory & thought processes?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Aug 09, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms and story you provide are complex and there is much information that I do not have. From the symptoms/history you describe I suspect you are having Left temporal lobe seizures and symptoms of Left temporal lobe dysfunction that may or may not be related to the seizures.
The Left temporal lobe (In right handed people, and most left handed as well) is the center of language function (along with the inferior frontal lobe. In addition a structure called the hippocampus is connected to the temporal lobe and is responsible for encoding memories. when people have dysfunction of the temporal lobe they can have seizures, memory loss, aphasia (language problems, such as naming, reading, repeating, articulating) and personality changes.
When people have repeated seizures in the temporal lobe this often causes chronic problems (atrophy/gliosis) in the hippocampus and memory problems are common. Another possibility is that the structural lesion you described "cholesterol granuloma" may be pressing on these structures causing the dysfunction.
An routine EEG (electroencephalogram or "brain wave test") is just a 20 minute snapshot of your brain activity. It often requires a multi-hour sleep deprived EEG or an admission for a 3-7 day epilepsy monitoring unit stay to adequately determine how often you are having seizures.
A final possibility is that anti-seizure medications can decrease your alertness and sometimes can cause memory/cognitive slowing, dizziness, double vision and ataxia (drunken walk). You should have a level checked to make sure you are not toxic on your neurontin (although I feel this is unlikely).
Given the symptoms you describe I would recommend more extensive EEG monitoring either the 2 hour sleep deprived or the admission to an epilepsy monitoring unit(EMU) for 3-7 days (I suspect you will need an EMU). From this data they can adjust your medication dose and/or add additional medications to stop your seizures. If you fail multiple medications, then you may be a candidate for epilepsy surgery to remove your seizure focus. Once your epilepsy is under better control, I believe your memory will improve, however sometimes the same pathology that gives rise to the seizures is causing the memory dysfunction and improvement may be limited. I would also suggest formal neuro-psych testing (not just MMPI) to evaluate your visual/verbal memory.
I hope this has been helpful.
The symptoms and story you provide are complex and there is much information that I do not have. From the symptoms/history you describe I suspect you are having Left temporal lobe seizures and symptoms of Left temporal lobe dysfunction that may or may not be related to the seizures.
The Left temporal lobe (In right handed people, and most left handed as well) is the center of language function (along with the inferior frontal lobe. In addition a structure called the hippocampus is connected to the temporal lobe and is responsible for encoding memories. when people have dysfunction of the temporal lobe they can have seizures, memory loss, aphasia (language problems, such as naming, reading, repeating, articulating) and personality changes.
When people have repeated seizures in the temporal lobe this often causes chronic problems (atrophy/gliosis) in the hippocampus and memory problems are common. Another possibility is that the structural lesion you described "cholesterol granuloma" may be pressing on these structures causing the dysfunction.
An routine EEG (electroencephalogram or "brain wave test") is just a 20 minute snapshot of your brain activity. It often requires a multi-hour sleep deprived EEG or an admission for a 3-7 day epilepsy monitoring unit stay to adequately determine how often you are having seizures.
A final possibility is that anti-seizure medications can decrease your alertness and sometimes can cause memory/cognitive slowing, dizziness, double vision and ataxia (drunken walk). You should have a level checked to make sure you are not toxic on your neurontin (although I feel this is unlikely).
Given the symptoms you describe I would recommend more extensive EEG monitoring either the 2 hour sleep deprived or the admission to an epilepsy monitoring unit(EMU) for 3-7 days (I suspect you will need an EMU). From this data they can adjust your medication dose and/or add additional medications to stop your seizures. If you fail multiple medications, then you may be a candidate for epilepsy surgery to remove your seizure focus. Once your epilepsy is under better control, I believe your memory will improve, however sometimes the same pathology that gives rise to the seizures is causing the memory dysfunction and improvement may be limited. I would also suggest formal neuro-psych testing (not just MMPI) to evaluate your visual/verbal memory.
I hope this has been helpful.
