2011
American Epilepsy Society Poster (Abst. 1.085)
Utility of an Outpatient Memory Treatment Program for Patients with Epilepsy
Authors: Drs. K. I. Lebeau, R. Trobliger, C. Mihaila, T. Copans, G. Ghacibeh, J. Politsky, S. Mesad, M. Lancman
Rationale:
Memory deficits represent one of the most common complaints of patients with epilepsy. Memory can be affected due to direct epilepsy consequences or secondary effects of antiepileptic drugs. Approximately half of all neuropsychology referrals present with complaints regarding memory functioning (Thompson & Corcoran, 1992). In order to address this problem, our neuropsychology department developed a memory remediation program specifically designed for epilepsy patients. Treatment focuses on training in compensatory strategies – helping patients in identifying new ways to compensate for their cognitive difficulties. This study examines the effectiveness of the program.
Methods:
All patients with epilepsy referred to the memory treatment program were included (n=25). All patients underwent video-EEG monitoring and had a confirmed diagnosis of epilepsy In order to qualify for the memory treatment group, patients underwent neuropsychological testing. If memory deficits were confirmed through this testing, they were considered as viable candidates for treatment. The mean age of the sample was 52.11, with a range of 26 to 71. The mean education level was 13.44 years, with a range of 8 to 20 years. All subjects participated in six sessions, with foci on attention, external strategies, internal strategies, and organization strategies. Each session involved a review of the previous week’s content and homework, a brief presentation, discussion, and provision of homework assignments for the next week. Prior to beginning the first session, participants were given multiple self-report questionnaires to complete including: the Memory Complaints Inventory (MCI-E), Quality of Life in Epilepsy Questionnaire-31 (QOLIE), Beck Depression Inventory – Second Edition (BDI-II), Beck Anxiety Inventory (BAI), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and the Cognitive Failures Questionnaire (CFQ). The same questionnaires were completed on the last session. Differences in mean scores pre- and post- group participation were calculated for the group using paired samples t-tests.
Results:
Significant differences were found for subjects on pre- and post- measures involving the MCI Total scale and the CFQ total (p <.01). A difference approaching significance (p = .051) was observed for the BAI total.
Conclusions:
Analyses demonstrated significant differences in mean scores on only a few scales. However, these scales were important ones as they are indicators of total experienced difficulties with cognitive functioning, including attention and memory, which were main foci of the memory group. The sample size of this study was small; however, the results are encouraging and indicate that at the very least these patients report improvement through participation in the group. The results also suggest that patients benefit from instruction in compensatory strategies; this is positive in that they can be applied easily and practically in daily life. Further research regarding the long-term effects of participation on levels of mood, anxiety, and cognitive complaints levels is needed.