The purpose of memory testing is to look for evidence of difficulty remembering that can occur from illnesses that affect cognition in general (such as dementing diseases) or from illnesses that affect memory alone (amnesic disorders).

The ability of your patient to recall recent and distant events is often evident during your conversation with the patient while you are taking the history. You should formally test memory when there is a complaint by the patient or the patient’s family of a problem with memory or any other cognitive difficulty, or when you suspect a disorder of memory or cognition from your conversation with the patient.

Definitions of the various aspects of memory differ depending on whether you are talking to a clinical neurologist or a neuropsychologist. Most neurologists simply divide the kinds of memory that we test (called episodic memory) into immediate recall, short-term memory, and long-term memory, and the following discussion defines these terms as they are commonly used and understood by most clinical neurologists.

Immediate recall (also called working memory) refers to the kind of memory that we use to remember things for seconds, and it should probably be thought of more within the realm of concentration than memory. Examples of immediate recall include remembering a telephone number for the few seconds before finding a piece of paper on which to write it down or remembering the beginning of a sentence before getting to the end of the sentence. The neuroanatomic localization for immediate recall is not clear.

Short-term (also called recent) memory refers to memory for events that occurred minutes, days, weeks, or even months ago. Examples of short-term memories include remembering what you had for breakfast this morning or for dinner last Sunday, or where you went on vacation last month. The brain structures that are involved in the ability to recall short-term memories are the hippocampi (which reside in the medial temporal lobes) and the thalami.

Long-term memory refers to memory for distant events, such as events that occurred years ago. Examples of long-term memories include remembering where you lived and went to school when you were a child. Where these long-term memories reside within the brain is not clear, but they probably are stored somewhere within and possibly throughout the cerebral cortex.

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