[Neuropsychology in epilepsy]

Abstract

Neuropsychological assessment has become an essential tool for the diagnosis and outcome control in the clinical management of epilepsy. However, only a few attempts have been made to formulate explicit guidelines about which cognitive domains should be addressed in epilepsy patients and which of the various coexisting neuropsychological tests would provide an appropriate and evidence-based assessment. The present survey among 14 epilepsy centres in German-speaking countries indicates that there is at least some consensus concerning the cognitive domains which need to be addressed. However, concerning test selection a large diversity of more than 200 applied psychometric tests among the different epilepsy centres becomes evident. Evidence-based test selection was only seen in 25 % of the applied instruments. One-third of the tests are conducted because of pragmatic reasons or due to subjective preferences, whereas for the majority of tests no justification is provided. Taking into consideration the bulk of publications on cognition and epilepsy, it is time to establish an evidence-based core test battery for the use in epilepsy patients. Therefore a closer communication between centres is needed to come to an agreement and to accumulate experience with already established and newly developed tests in order to promote evidence-based neuropsychology in the field of epilepsy.