Self-reporting of everyday memory in patients with epilepsy: relation to neuropsychological, clinical, pathological and treatment factors

Patients with epilepsy frequently complain of memory problems, but neuropsychological tests sometimes fail to detect consistent deficits; this may be because laboratory tests are poor indicators of everyday memory problems, or because subjective memory difficulties may be provoked by a variety of factors. To address these issues, we compared 100 patients with epilepsy and 57 healthy controls by means of our Questionnaire of Memory Efficiency, the State-Trait Anxiety Inventory, the Self-Rating Depression Scale and a battery of tests. The Chronbach test showed the Questionnaire of Memory Efficiency to be satisfactorily reliable. Patients reported significantly greater memory difficulties and higher levels of anxiety and depression than controls. Questionnaire of Memory Efficiency scores correlated with anxiety and depression levels, as well as with memory and learning test scores and regression analysis showed that anxiety, depression and visual learning had the most consistent explanatory power. No correlation was found with clinical variables or the presence of detectable brain lesion. Patients undergoing polytherapy or treatment for long periods reported the greatest memory difficulties. These findings suggest that subjective perception of memory failure reflects objective memory impairment. However, emotional factors and low self-esteem may bloat the reporting of everyday memory difficulties. The Questionnaire of Memory Efficiency seems able to provide information about everyday memory problems in patients with epilepsy that may be useful for planning neuropsychological counselling or rehabilitation. (C) 1997 Elsevier Science B.V.