Abstract
It is evident that in chronic epilepsy--both symptomatic and nonsymptomatic--cognitive dysfunction precedes the onset of seizures. Cognitive disorders emerge with the underlying lesion or the concomitant physiological process. The presumed additive effect of seizures has not been decisively clarified. The degree of damage may consecutively accumulate with a disease duration of more than three decades and an unfavorable course with frequent secondary generalized seizures. Long-term follow-up investigation of cognition in different epileptic syndromes is needed to address the question of their specific role in cognitive decline. Treatments successful in seizure control may however also hold cognitive risks. Additional memory impairment due to the surgical treatment of left-sided temporal lobe epilepsy ranks first among them. Cognitive side effects of antiepileptic medication may have considerable adverse effects on patients. The need of individual assessment of cognitive side effects draws increasing attention as a precondition for treatment optimized to each patient.
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