Veronica Hackethal, MDJun 14, 2017Epilepsy and Seizure Here’s evidence that accelerated long-term forgetting (ALF) may be an important memory disorder in subgroups of patients with epilepsy. Accelerated Long-Term Forgetting: Overlooked in Epilepsy?ALF is memory loss that occurs after days or weeks in a patient with normal short-term memoryIncidence rates and underlying causes of ALF in epilepsy are unknown Standard memory testing usually evaluates shorter term memory deficits, and may not detect ALFResearch suggests that some patients with epilepsy may experience ALF, especially those with temporal lobe abnormalities New insights on ALF in Focal EpilepsyConducted at the University of SydneyIncluded 44 patients with focal seizuresUsed two standardized, 15-item lists to test memory at 30 minutes and 7 days: Rey Auditory Verbal Learning Test (RAVLT): tests word recallAggie Figures Test: tests recall of abstract line drawingsALF: normal short-term results, impaired 7-day resultsCompared results to a control group of 60 patients without neurological or psychological history ALF Increased in Focal EpilepsyNearly twice as many patients with focal seizures showed ALF vs controls (23% vs 12%) 33% of patients with ALF had temporal lobe epilepsyHippocampal lesions were the main predicting factor -ALF found in 41% of patients with hippocampal lesions vs only 11% without (p<.05) Test Type Influences Detection of ALFRates of ALF differed based on test type: -RAVLT: 18% of patients with focal epilepsy had ALF -Aggie Figure Test: 7% of patients with focal epilepsy had ALF Standard Testing May Miss ALF in Focal Epilepsy Patients with focal seizures may show memory deficits at longer delays than standard evaluation can pick upAdding long term recall questions to standard memory assessments may detect ALFALF may be most common in temporal lobe epilepsy with hippocampal lesions Take Home Points.Small, single center study adds to evidence that ALF may be an important memory disorder in epilepsy.ALF prevalence may be higher in patients with temporal lobe epilepsy with hippocampal lesions.Standard testing may miss ALF.Incidence of ALF may vary based on type of test; testing word recall after one week may be particularly helpful in detecting ALF in focal epilepsy 1. Miller LA, Mothakunnel A, Flanagan E, et al. Accelerated Long Term Forgetting in patients with focal seizures: Incidence rate and contributing factors. Epilepsy Behav. 2017;72:108-113.