Neuropsychological aspects of epilepsy

Brain dysfunction between seizures is common in epilepsy and a systematic assessment of it assists in planning directed programs of remediation. A battery of well-validated neuropsychological tests formulated with the needs of persons with epilepsy in mind can be of particular help in this regard. Increasing impairment in brain functions is shown to be associated with increasing emotional problems. Medical variables pertaining to seizure history include seizure type, cause, age at onset of seizures, duration of disorder, and seizure frequency. An exploration of relationships between these variables and measures of abilities and adjustment reveals a number of findings, some of which are complex. A review of the cognitive effects of antiepileptic drugs shows that the barbiturates have at least slightly greater adverse cognitive and behavioral effects than other drugs including carbamazepine, phenytoin, and sodium valproate. Whether cognitive differences exist among these latter medications is currently in question. Carbamazepine has the best-established favorable psychiatric effect.