The role of neuropsychology in the assessment and treatment of persons with epilepsy.

Abstract

Several areas of current interest in the neuropsychology of epilepsy are briefly reviewed in this article. These include variables pertaining to seizures, seizure history, antiepileptic drugs, and methods of neuropsychological evaluation. It is apparent that epilepsy is a multifaceted area: Psychologists not only can be of great assistance to patients with this condition, but may also learn a great deal from this complex disorder.

Comorbid Psychiatric Symptoms in Temporal Lobe Epilepsy: Association with Chronicity of Epilepsy and Impact on Quality of Life

“…It is generally accepted that the risk of interictal psychopathology is elevated among patients with chronic epilepsy attending tertiary care clinics (5,6,9,16). Thus, the fact that patients with temporal lobe epilepsy self-reported more emotional-behavioral distress on the SCL-90-R is not surprising.…”

Executive Performance on the Wisconsin Card Sorting Test in Mesial Temporal Lobe Epilepsy

“…The lack of agreement of these results may be due to differences in clinical and treatment-related factors [38]. Since repeated epileptic discharges can result in structural alterations [39], seizure frequency and duration of epilepsy may influence cognitive functions in TLE patients.…”

Epilepsy and Aging

“…The few studies of elderly epilepsy patients suggest they also have signi fi cantly lower QOL compared to the general population [ 93,103 ] . On epilepsy-speci fi c QOL measures [ 35,104 ] , elderly patients with epilepsy generally do not experience poorer QOL compared to younger patients, but QOL can suffer in those with new-onset epilepsy, especially those diagnosed after retirement [ 103,104 ] . As just one example of the potential longreaching impact of the illness, veterans with epilepsy were about 1.5 times more likely than those without to report getting no regular exercise which, among other things, may lead to decreased muscle mass, falls, hip fractures, and frailty [ 103 ] .…”

“…In one study, results remained stable over a 3-year period [ 38 ] , although there was failure to bene fi t from a test-retest effect. Early age of onset of epilepsy, a known etiology, and a high number of years with seizures, number of years taking medications, number of medications taken, and lifetime number of generalized tonic-clonic seizures are factors that have been associated with poorer neuropsychological functioning in the general population of patients with epilepsy [ 35 ] . Other factors associated with cognition are brain lesion, genetic abnormalities, seizure frequency, type of seizure, SE, and surgery [ 119 ] .…”

“…In addition to chronological age, a patient's biological age, based on a physician's clinical judgment, is an important factor when medication choices are made [ 14,19 ] . Attempting to minimize AED side effects while also controlling seizures is a delicate balance [ 22,33,35,39 ] .…”