Epilepsy and Neuropsychology

Neuropsychological evaluation is an essential component of clinical care for people with epilepsy, given the increased risk for cognitive impairment, psychiatric comorbidities, and psychosocial difficulties ( Box 1 for common referral questions). Neuropsychology also has a specialized role in predicting cognitive outcome after epilepsy surgery. Neuropsychological research in the field of epilepsy initially advanced our knowledge regarding memory and language systems, as well as lateralization of cognitive functions. More recently, advanced neuroimaging methods have revealed epilepsy to be a network disorder, even in the setting of focal epilepsy syndromes. Several prediction models have been developed for post-surgical outcome prediction at the individual level for people who undergo left temporal lobectomy and cognitive phenotyping methods highlight the heterogeneity in cognitive functioning among people with epilepsy. Pre-rehabilitation methods and interventions to support healthy lifestyle factors may improve cognitive outcomes following surgery and reduce accelerated cognitive aging in epilepsy. In the era of precision medicine, the development of tailored interventions that consider the impact of health disparities, cognition, psychological functioning, individual risk and resilience factors, and modifiable lifestyle factors, are critical for optimizing cognitive functioning, psychological health, and QoL for people with epilepsy.