Neuropsychological assessment protocol for adults in epilepsy surgery

Abstract

Refractory epilepsy means that the seizures are untreatable, and therefore one of the interventions that makes it possible to eliminate them or to accomplish a reduction in the number of seizures is neurosurgery. A neuropsychological evaluation model aimed at measuring the cognitive performance of adult patients who are candidates for epilepsy surgery is proposed. In line with the proposals most frequently put forward by the various reference centres for epilepsy, an open protocol is proposed that is aimed at obtaining a baseline of overall cognitive performance, cognitive reserve and manual dominance, as well as cognitive processes such as attention, language, visuoconstructive and manipulative skills, memory and executive functions, among others, without neglecting the psychopathological examination and the patient's quality of life. This, together with the results of other diagnostic specialities, will contribute to the localisation and minimisation of the cognitive sequelae secondary to the surgical intervention on the epileptic focus, as well as to providing information to the medical team responsible for the case and to patients and relatives about the possibilities and prognosis of the intervention. It is necessary to have a battery of techniques and an adequate consensus when evaluating the data obtained. An assessment model is proposed that allows information to be obtained about the neuropsychological profile of the candidate for epilepsy surgery, which is open to debate and serves as a model for discussion by the other epilepsy reference centres.