36. Cognitive Effects of Chronic Epilepsy

  1. John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery3 and
  2. Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology4
  1. Daniel L. Drane1,2

Published Online: 10 JAN 2014

DOI: 10.1002/9781118456989.ch36



How to Cite

Drane, D. L. (2014) Cognitive Effects of Chronic Epilepsy, in Epilepsy (eds J. W. Miller and H. P. Goodkin), John Wiley & Sons, Oxford. doi: 10.1002/9781118456989.ch36

Editor Information

  1. 3

    University of Washington, Seattle, WA, USA

  2. 4

    Department of Neurology, University of Virginia, Charlottesville, VA, USA

Author Information

  1. 1

    Departments of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

  2. 2

    Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA

Publication History

  1. Published Online: 10 JAN 2014
  2. Published Print: 14 FEB 2014

ISBN Information

Print ISBN: 9781118456941

Online ISBN: 9781118456989



  • Cognitive function in epilepsy;
  • Neuropsychological assessment;
  • Outcome prediction;
  • Disease-related variables and cognition;
  • Interictal epileptiform discharges


This chapter reviews patterns of cognitive functioning in patients with epilepsy and provides a framework to understand patient performance in terms of variables such as age of seizure onset, seizure frequency, epilepsy duration, etiology, and epilepsy syndrome. This chapter reviews the clinical methods used to measure neuropsychological function and highlights neural mechanisms underlying cognitive change and improvement. Distinguishing transient causes of cognitive dysfunction (e.g., interictal epileptiform activity and medication adverse effects) from baseline performance is emphasized. The goal is to provide a mechanistic approach to estimating cognitive ability based on available patient information, to facilitate ongoing reassessment of benefit and risk associated with potential treatments, and to project the likely future trajectory of the patient's function.