Memory complaints in the epilepsy clinic.

Cognitive complaints in people with epilepsy are usually multifactorial in their nature and origin. While antiepileptic medications are an important consideration, we explore other ways in which neurologists can address cognitive problems in this population. It is never too early to ask about cognitive impairment, and the answers can have diagnostic significance. Understanding and accepting that cognitive problems may result, at least in part, from the same pathological process that generates seizures is an important part of the rehabilitation process. Patients referred for neurorehabilitation for cognitive difficulties who have realistic expectations and goals tend to benefit more from the intervention than those expecting a cure. Developing an understanding of this and managing patient expectations should start in the neurology clinic. Although we focus primarily on memory function, the principles we discuss in this paper apply to the broad spectrum of cognitive and neurobehavioral problems that accompany the many diagnoses of epilepsy.