Epilepsy and Neuropsychology

UNIT 14

Grammar: The Complex Object

Most people living with epilepsy do not experience serious problems with their thinking. However, there are aspects of thinking that can be affected by recurrent seizures and/or their treatments. Neuropsychologists use standardized tests to examine different aspects of thinking (such as memory, attention, and problem solving) and behaviour to better understand a person’s individual profile of abilities and challenges (strengths and weaknesses). With this information, a neuropsychologist can identify brain structures or systems that may not be working efficiently and make suggestions for treatments or supports that can help a person function to maximum capacity.

A person living with epilepsy may be referred to a neuropsychologist if they are noticing problems with their ability to learn and remember information, pay attention and focus, finish projects, express themselves clearly, etc. When evaluating how seizures can influence one’s neuropsychological function, several factors need to be considered:

1) The type and location of seizures in the brain. There are several different types of epilepsy syndromes. Some epilepsy syndromes are considered relatively benign and have very little effect on thinking skills. Other types of epilepsy are more severe and are associated with more significant neuropsychological impairment. 2) The frequency and severity of seizures. People with more frequent and severe seizures or people who have seizures that are very long have a greater chance of experiencing changes in their thinking. 3) Length of Illness. The longer a person has been having seizures, the greater the chance of thinking difficulties. Seizures that begin in infancy are known to be particularly harmful to thinking abilities, in part because the brain is still developing and the seizures are affecting the way the

brain develops. 4) The underlying cause of the seizures. People have seizures for many different reasons. Some people with epilepsy have subtle abnormalities in the way their brains are structured or the way their brains function. For others, seizures are the result of some kind of acquired brain injury (e.g., stroke, infection, head injury). The underlying cause of a person’s seizures is the best predictor of the type and extent of thinking problems a person may experience.

What types of thinking problems are commonly experienced by people diagnosed with epilepsy? 1) Attention is a foundational neuropsychological function, mediated by the frontal lobes. Before one can process, learn, or respond to something, one must first focus and attend to it. Problems with attention can undermine all other aspects of thinking and learning. There are many aspects to attention, but the aspects that are most relevant to epilepsy have to do with the ability to focus and concentrate on something while ignoring distractions (ie,

selective attention) and the ability to sustain focus and concentration over long periods of time (ie sustained attention).

2) Executive Functions. Executive functions are a group of skills involved with regulating our thinking and behaviour. Executive functions guide our problem solving and decision making and are crucial for successfully managing more complex tasks or ideas. Skills that make up the executive functions include: organization and planning, self-monitoring, the ability to sequence, the ability to shift or switch ideas or plans if something is not working, the ability to persist or carry-through on something, and the ability to inhibit or stop oneself from doing or

thinking something.

3) Learning and Memory: The most common thinking problem reported by people living with epilepsy is poor memory. Learning and memory is a multi-staged process involving the (1) encoding of information, (2) storage of information, and (3) retrieval of information over time. A breakdown at any stage results in poor memory, but for different reasons.

4) Speed of Processing: Speed of Processing refers to how quickly a person can process and absorb new information and respond to it. Recurrent seizures and seizure medications can slow a person’s speed of processing. When processing speed is slowed, it can feel as if everything is on “fast-forward” and a person can have trouble keeping up.

5) Information Processing: Information processing refers to how people understand and make meaning of the information they hear or see. Broadly speaking, there is language-based processing (understanding language) and visually-based processing (understanding visual images). People may have trouble understanding what someone is saying to them or struggle to use the right words to express themselves. For others it is difficult to see patterns in designs or details in pictures.

Для упражнений этого урока

What can a person living with epilepsy do to minimize the impact of neuropsychological challenges on day-to-day functioning?

Use the pattern: It is important/necessary for a person with epilepsy who is experiencing thinking problems to…

(talk to their doctor; undergo additional diagnostic procedures such as blood work, additional EEGs, or brain imaging; to see a neuropsychologist;)

What can a doctor do to help the person experiencing thinking problems?

The doctor can… (attempt to sort out possible reasons for the thinking problems; refer a person with thinking problem to see a neuropsychologist; to identify the nature and type of thinking problems; to identify strategies and interventions that are necessary.)

Read the following strategies can help people to optimize their cognitive functions. Say which of them you use, give reasons why you find them efficient.

Дата добавления: 2014-11-08