Pre-postoperative neuropsychological assessment in the surgical treatment of epilepsy

Introduction. Epilepsy is one of the most common neurological disorders, affecting about one percent of the world population. Pharmacological treatment fails irt one-third of these patients. Surgical intervention has become an accepted treatment option for those patients with seizure disorders that are refractory to conventional therapies. Cortical resection and callosotomy are the most widely accepted,methods of surgical intervention. A prerequisite for success in this type of surgical intervention is the preoperative clinical assessment of the epilepsy, surgery candidate. Development. This paper examines the current uses of neuropsychological assessment in an epilepsy surgery program. Several areas are addressed for discussion with respect to the contributions of neuropsychological assessment: the preoperative evaluation of the epilepsy surgery candidates, including the clinical examination of language and memory functions during the Wada test; the neuropsychological changes that result from surgery and the predictive role of neuropsychology in these areas, and prediction for seizure control following surgery. Conclusion. Assessment of cognitive functions is an important component of the preoperative evaluation of the epilepsy surgery candidate, and is needed in order to obtain complete diagnostic information.