Neuropsychiatry and Neuropsychology in Epilepsy Surgery

Abstract

Treatments of intractable epilepsy by neurosurgical operations have been prevailed in Iran. The success rate completely depends to precise comprehensive evaluations. The purposes of Comprehensive Epilepsy Program (CEP) are to delineate the source of epilepsy, to describe current burden of attacks, and to suggest outcome of surgery. The pre-operative assessment includes video EEG monitoring, structural and functional neuroimaging and neuropsychological evaluation. The likelihood of the success of surgery is increased when all test results point to a single epileptogenic focus. The cognitive and behavioral evaluations include standard neuropsychological assessment and intracarotid anesthetic testing (Wada). The role of neuropsychology is its potential to predict lateralization and perhaps localization of a brain pathology based on deficits in cognitive function. Neuropsychological assessments can also demonstrate cognitive dysfunction in conditions that structural brain lesion is not detected. The Wada test has been used to determine the cerebral speech dominance and to predict postsurgical amnesia after temporal lobectomy.