Should every child with epilepsy undergo a neuropsychological evaluation?

Neuropsychological (NP) testing has always been an important part of the presurgical workup of patients with epilepsy. Yet, there is no agreement on the timing or circumstances in which NP testing should be ordered in the evaluation of children with epilepsy. This article addresses this controversial question. The early identification of learning or of mental health problems constitutes one of the arguments in support of NP testing. The relative unavailability and high cost of NP testing, the potential inappropriate labeling of children as "learning disabled," and the risk of attached stigma are some of the arguments in support of limiting NP testing to children suspected of having cognitive or behavioral problems. Nevertheless, we concur that at the least, the need for NP testing should be considered by clinicians in the course of their evaluation of every child with epilepsy.