Neuropsychology of Epilepsy

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Birmingham 2006

• Neuropsychology of Epilepsy
• III
• Pam Thompson
• Department of Clinical Experimental Epilepsy,
• Institute of Neurology
• National Society for Epilepsy

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Memory

• awareness by the person
• can take steps to minimise problems
• reduced insight?
• awareness by family and carers
• reduce misunderstandings
• masked by routine

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Environmental adaptations

• arrange environment so less reliant on memory
• labelling doors/ cupboards
• toilet doors different colour
• words pictures
• mark out routes arrows/ symbols
• inside and outside buildings
• way to the toilet
• name badgespictures staff
• establish routinesavoid changes

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External memory aids

• take the strain off the brain
• notebooks eg by telephone
• personal environmental cue
• time tables
• external prompts family/carer,digital
  watches,mobile phones
• electronic organisers
• diaries forthcoming eventsrecord of what done
• training to use
• hourly bleeps

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Tuesday 19th Feb Wednesday
20th Feb
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Internal memory aids

• mnemonics
• mental manipulation
• concentration
• rote learning
• visual imagery

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Internal memory aids

• visual imagery
• deeper encoding
• rhymes songs
• months of the year
• first letter ROYGBIV
• My very earnest mother just served us nine
  pickles
• peg method
• locations

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Remembering what said

• simplify information
• reduce amount given at any one time
• ensure minimal distraction
• make sure understood- repeat back
• encourage deeper encoding
• use external aids wherever possible

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Remembering the past

• memory trace rapidly degrades
• eg holidays,family events
• past experiences
• contributes to sense of self
• forms basis of conversations
• preserving the past
• dictaphone diaries
• photographs
• videos
• personal history

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Executive skills deficits

• frontal lobes lobes
• next most epileptogenic region
• executive skills ?
• more handicapping then memory problems
• reduced insight
• difficulty goal selection unrealistic
• planning how to get to the
  goal
• starting a plan
• focusing on goal
  distractible
• monitoring

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Executive skills deficits

• control system malfunctioning external guidance
• select appropriate goal
• break down into small manageable steps
• devise visual verbal prompts
• training sessions frequently regularly
• ideally where activity takes place
• problems of transfer of skills
• with time prompts can be reduced
• behaviour becomes a habit over-learned
  routine

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Kitchen drinks meals

• Beans on toast
• Cauliflower cheese
• Hot chololate
• Jacket potato with tuna
• Scrambled eggs
• Shepherds pie
• Tea
• Vegetable rissotto

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Making a cup of tea

• fill up the kettle with water
• dont forget to switch the electricity on
• find the mugs in the cupboard above the kettle
• get the milk out of the fridge
• find the tea bags (they should be in the cupboard
  next to the mugs)
• put one in the teapot for each person
• check water has boiled
• pour over tea bags
• enjoy!

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Neuropsychologist role

• assess cognitive strengths weaknesses
• cognitive impairmentshidden
• contribute to diagnosis
• partial v generalised
• progressive conditions
• Identification of surgical candidates
• counselling re cognitive prognosis
• assess impact of medication
• cognitive rehabilitation
• research