SpeechPathology.com Phone: 800-242-5183

AMN Healthcare

Temporal Lobe Epilepsy and Cognition

Rima Abou-Khalil, PhD, CCC-SLP

September 30, 2016



How does temporal lobe epilepsy impact cognition? 


Temporal lobe epilepsy is the most common form of epilepsy.  It is well studied and the deficits in temporal lobe epilepsy are well known. Seizures often begin in the hippocampus which is responsible for memory. If it begins in the dominant hippocampus, there will be verbal memory impairments and in the non-dominant hippocampus, visual spatial memory might be affected.  The earlier the onside of temporal lobe epilepsy, the greater the memory impairment.

Then, not surprisingly in epilepsy populations, depression is a common co-morbidity. Depression and epilepsy together affect memory even more than if the person didn't have a co-existing depression.

Other cognitive deficits with temporal lobe epilepsy may include IQ, executive functioning and language. With dominant temporal lobe epilepsy, impaired naming is a common co-morbidity.

Another problem with temporal lobe epilepsy is that the earlier the onsite, particularly if the onset is in childhood or in infancy, the greater the likelihood of cerebral reorganization for language. Patients with early onset temporal lobe epilepsy of the dominant lobe tend to have atypical language distributions. They may either have bilateral language distribution or the language might shift entirely to the intact non-dominant side. This shift to the right hemisphere is associated with deficits of its own, particularly in non-verbal language. The organization's not considered to be extremely beneficial in temporal lobe epilepsy of early onset.

Cognitive disturbances in epilepsy are not static. They tend to get transiently worse after a seizure. A person who has a seizure can have a period of time called the “post ictal period”, which is characterized by the ending of the clinical seizure. The person is no longer shaking or trembling. However, the electrical activity continues to be impaired in the brain.  During that post ictal period, there can be post ictal aphasias, particularly if the epilepsy is generated in the dominant temporal lobe.

Electrical disturbances can occur without clinical manifestations and they can cause transient impairments. The expectation is that the anti-epileptic drug will improve cognition by reducing the impact of the seizure. The AEDs will improve cognition because they lower these transient impairments. Therefore, the person should be able to recover cognitively sooner rather than later.

Rima Abou-Khalil received her Ph.D. from Vanderbilt University in 2003.  She is currently a faculty member at Vanderbilt University with clinical and research interests in acquired neurogenic disorders. 

rima abou khalil

Rima Abou-Khalil, PhD, CCC-SLP

Rima Abou-Khalil received her Ph.D. from Vanderbilt University in 2003.  She is currently a faculty member at Vanderbilt University with clinical and research interests in acquired neurogenic disorders. 

Related Courses

Behavioral Frameworks for Dementia Management
Presented by Mary Beth Mason, PhD, CCC-SLP, Robert W. Serianni, MS, CCC-SLP, FNAP


Mary Beth Mason, PhD, CCC-SLPRobert W. Serianni, MS, CCC-SLP, FNAP
Course: #9473Level: Intermediate1 Hour
  '2 presenters that shared the load of communicating this information to us'   Read Reviews
This course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.

Dysphagia in Neurodegenerative Disease
Presented by Debra M. Suiter, PhD, CCC-SLP, BCS-S


Debra M. Suiter, PhD, CCC-SLP, BCS-S
Course: #9732Level: Intermediate1 Hour
  'This course taught me a great deal about ALS and reinforced knowledge of dysphagia in Parkinson’s, esp tx'   Read Reviews
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.

Best Practice for Assessment and Treatment of Bilingual Aphasia
Presented by Maria Muñoz, PhD, CCC-SLP


Maria Muñoz, PhD, CCC-SLP
Course: #9759Level: Intermediate1.5 Hours
  'The quality of information and the presentation of it in a very organized and easy to understand matter'   Read Reviews
This course focuses on best practice in the assessment and treatment of bilingual aphasia by speech-language pathologists. Recommended practices are contrasted against common mistakes made by clinicians working with bilingual patients with aphasia. Implementation of best practices are modeled through case studies.

Social Isolation and COVID-19 Cognitive Decline: From Zero to Hero!
Presented by Amber B. Heape, ClinScD, CCC-SLP, FNAP, CMD, CMDCP


Amber B. Heape, ClinScD, CCC-SLP, FNAP, CMD, CMDCP
Course: #9514Level: Intermediate1 Hour
  'Great information for all healthcare providers'   Read Reviews
Social distancing and isolation associated with the COVID-10 pandemic have begun to take a toll on patients in residential settings, but SLPs can help mitigate the long-term consequences. This course will discuss the risk factors for and effects of isolation, as well as potential strategies to prevent or reverse pandemic-related cognitive decline.

Brain Health Basics: Strategies for SLPs to Support Healthy Aging for Adult Patients
Presented by Megan L. Malone, MA, CCC-SLP, Jennifer Loehr, MA, CCC-SLP


Megan L. Malone, MA, CCC-SLPJennifer Loehr, MA, CCC-SLP
Course: #9785Level: Introductory1 Hour
  'Reinforced what we should be doing for brain health (even for ourselves)'   Read Reviews
This Back to Basics course focuses on the preventative aspect of improving brain health with adult patients, with emphasis on elements that SLPs can target during instruction or counseling aspects of patient treatment and caregiver support. Additional information is provided on advocacy for these services and community outreach to organizations working with older adults.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.