[Neuropsychological diagnosis in patients with epilepsy]

Patients with epilepsy are at higher risk to demonstrate cognitive impairment compared with the normal population. A variety of interacting epilepsy related factors (e.g. lesion, epileptic activity, and antiepileptic medication) may influence the cognitive profile of patients. Neuropsychological tests provide information about the individual quality, severity, and dynamics of attentional, perceptual, mnestic, cognitive, mental speed, and psychomotor speed impairments. The interpretation of test data has to consider the etiology, the localisation of an underlying pathology, the frequency and severity of seizure activity, status epilepticus, the frequency and distribution of epilepsy typical discharges, antiepileptic drugs, the age at seizure onset, the duration of epilepsy, education, and possible effects of epilepsy surgery. Longitudinal studies allow the description of natural courses and of therapeutic effects including side-effects. Especially patients who are confronted with high professional and educational cognitive demands and who are at considerable risk of side effects may benefit from neuropsychological diagnostics prior to and following therapy decisions.