Neuropsychiatric and memory issues in epilepsy.
Epilepsy is an extremely complex disorder characterized by marked variability in clinical presentation, etiology, diagnostic certainty, and therapeutic options. Neuropsychiatric and cognitive concomitant disorders are equally diverse and complex. Depression and anxiety, for example, may be preexisting conditions, occur only in peri-ictal or ictal states, or persist as constant interictal phenomena; both place additional burden on memory functions, which are further taxed by the effects of recurrent seizures, temporal lobe insult, and antiseizure medications. Such factors present considerable clinical challenges, particularly in outpatient settings. This article provides an overview of major psychiatric features of epilepsy and of issues regarding the nature of memory deficits in this neurologic population. The importance of identifying and treating potentially reversible causes of memory impairment and related forms of cognitive impairment is emphasized.