Subjective Memory Complaints in Temporal Lobe Epilepsy What Contributes to an Experience of Memory Dysfunction?

Patients with temporal lobe epilepsy (TLE) often present with subjective memory complaints (SMC) that cause significant distress and impact their quality of daily life (Giovagnoli and Avanzini, 2000). Sometimes, these complaints do not correlate with Objective memory test (OMT) scores (Hall et al, 2009). Memory deficits are important variables in planning treatment and predicting surgical outcome. Hence, identifying factors that influence SMC helps in planning effective treatment.

Objective: To delineate predictors of subjective memory complaints.

Methods: Retrospective data analysis of 97 adult patients who had (1) left mesial TLE, (2) underwent comprehensive neuropsychological examination, (3) IQ > 70. A stepwise binary logistic regression was conducted using data from clinical history and test scores for independent variables—demographics (age, gender, education, and occupation), intelligence, memory tests (R-AVLT, paired associates and complex figure test), seizure, medication, mood, and psychosocial factors (stigma and overprotection) as predictors of SMC.

Results: Seventy-five patients (77.31%) reported SMC, of which one fourth (25.33%) showed no impairment on any OMT. The regression model indicated two significant predictors of SMC, mood issues and one memory test (paired associates) score, ξ² = 14.93, p < 0.001.

Conclusion: The odds of reporting SMC increased with the presence of mood issues and poor performance on one memory test. Mood issues appear to be an important factor impacting memory significantly and resulting in subjective experience of problems despite no impairment in most Objective tests. It is important to elicit subjective complaints and address the mood issues to reduce burden of memory dysfunction in patients with epilepsy.