Cognitive impairment in epilepsy: State of affairs and clinical relevance

Abstract

The consequences of epilepsy are often as serious as having the disorder itself. One particularly important consequence is the impairment of cognitive function. Cognitive function is a higher order behavior–—that is, the capacity of the brain to program adaptive behavior, solve problems, memorize information, and focus attention. Epilepsy is a symptom of ictal and interictal brain dysfunction. Hence, it seems obvious that cognitive impairment develops as a symptom secondary to the epilepsy. Memory impairment, mental slowing, and attentional deficits are the most frequent cognitive disorders associated with epilepsy. Sometimes, individual patients find these cognitive consequences more debilitating than the actual seizures. Although the exact cause of cognitive impairment in epilepsy has not been fully explored, it is clear that three factors are involved: the syndrome, that often also includes the etiology, the seizures, and the ‘‘central’’ side effects of treatment. In October 2005 a group of Dutch and Flemish clinicians and researches met in the city of Maastricht in The Netherlands in an attempt to review the existing evidence in this field. Three articles in this special issue cover these areas. An additional