Language terms
To discuss language, we need to use some terms from linguistics, the formal field of language study. Most linguistic theories divide language into three major components, which form the building blocks of every language:
Phonology - the study of speech sounds (phonemes) and how they are used
Syntax - the rules governing relationships among words and how they can be used together to express a thought
Semantics - the aspects of language involved in relating words to meaning. Semantic representation refers to the way that information about words and categories is stored in the brain.
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Top Ten Memory Complaints
After years of evaluating patients with memory complaints, we have compiled a list of the most commonly reported complaints. Some of these reflect primary problems with memory. Others reflect a disturbance in other areas, including attention and concentration. Read on in this section to learn about how epilepsy relates to these types of symptoms.
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I Can't Come Up with the Right Word...
Adults with partial epilepsy commonly describe difficulties in coming up with words. This is the most frequently reported disturbance of language in people with complex partial seizures. It is also the symptom that has received the most attention in medical and scientific studies. Neuropsychological research has shown that patients with partial epilepsy affecting the left temporal lobe have greater difficulty in naming objects and pictures than patients with seizures originating from other parts of the brain. These individuals also have problems coming up with words to describe things, and may do poorly when asked to think of as many words as possible in a certain category.
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Causes of Memory Problems
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.
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Diagnosing Language Problems
Neuropsychological testing outlines strengths and weaknesses in a number of functions, including language. Standardized tests of vocabulary, naming, and word retrieval are particularly useful for objectively documenting whether these specific language functions are intact. Most testing also assesses a broader range of verbal skills as well as language-based academic skills such as reading and spelling.
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Types of Language Problems in Epilepsy
Physicians and scientists have long been intrigued by the variety of ways that language can be affected by brain disease. It is clear that epilepsy can affect language, but the extent and nature of the language disturbance varies widely according to the type, severity, and cause of the epilepsy.
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Is there an epileptic personality?
Epilepsy has significant effects on the behavior of most people who have it. In some cases the seizure activity itself is manifested as a brief change or interruption in behavior that might appear unusual to the casual observer. Evidence also suggests that epilepsy can affect behavior when seizures are not occurring. Descriptions of interictal (between-seizure) behavior in people with epilepsy have a long and controversial history. Through the ages, those with epilepsy have been thought to be either blessed with divine powers or marked by evil. Through the 19th century, many considered them insane or thought they had reduced mental and moral powers. The level of public misconception has decreased over time, but many biases about epilepsy and its resulting behavior continue to this day.
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Causes of Language Problems
For some patients with epilepsy, it is thought that the seizure medicines they take may be causing some of their language problems. In particular, disturbances in naming and comprehension have been associated with use of some of the newer medications, such as Topamax (topiramate). With our current understanding of the actions and effects of these medications, however, it is difficult to understand how they could specifically affect language and not other mental functions. It appears that reported language problems are likely to be a secondary result of more general effects on cognition or attention rather than a disturbance in language alone.
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Language and Epilepsy
Language is a broad term that is used to describe our system of communicating with each other by symbols. This system has specific rules that govern the ways we use sounds, letters, and words to express ourselves. Language is a unique capability that many consider intrinsically linked to thought itself. It is often seen as a significant component of our intelligence and one of the major things that separate us from other animals.
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Impairment of consciousness: What does it mean?
A simple definition of "consciousness" is the ability to respond and to remember. With some kinds of seizures, you will not recall the seizure and may not even know that you have had one. How is this possible? In a way, it's like being asleep or under anesthesia. You don't remember what happens to you or around you in those situations either.
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The brain and executive functions
Like all forms of behavior, executive functions result from the activity of the entire brain, but these abilities have been linked more specifically to the functions of the frontal lobes. Years of brain research have shown that the most severe and extensive disorders of executive functioning occur in patients with specific disorders of a system involving the frontal lobe and its extensive connections to lower centers of the brain, including the thalamus and basal ganglia.
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Executive functions and epilepsy
Executive functions include a set of abilities that are necessary to organize the performance of these other cognitive functions, to make changes when necessary, and essentially to "run the show." They directly involve our ability to have insight into our own behavior and awareness of its effects.
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Treating problems with executive functions
Deficits in executive functions can be very difficult to treat. Some people who are overly susceptible to distraction can be helped to focus by using a mild psychostimulant such as Ritalin. It remains unclear how this kind of medication affects other cognitive functions. Research is continuing on the best way to use these medications in various situations.
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Diagnosing and Treating Memory Problems
What should you do if you think you have a problem with memory related to epilepsy? The first thing is to have a frank discussion with your doctor, expressing your concerns about memory. Having treated you and your particular type of epilepsy, your doctor is in a position to consider the probable impact of neurobiological factors like brain abnormalities and seizures as well as the effects of your epilepsy treatment. Your doctor might decide to change your treatment immediately, perhaps by lowering the dose of one or more medications or even changing the approach altogether.
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