Childhood epilepsy is one of the most prevalent forms of chronic and disabl
ing childhood disorders. Because it disrupts brain maturation, it has long
been thought to produce non-specific consequences such as mental deficiency
and behavioral problems. However, advances in medical knowledge have shown
that childhood epilepsy should not be considered as a single disorder, and
it is now becoming apparent that various clinical entities have different
cognitive expressions that yet need to be specified. The purpose of this pa
per is to provide an up-to-date analysis of this multi-faceted pathology. T
he first section is devoted to the characterization of the neuropsychologic
al profile that accompanies focal epilepsies, as defined by the site of the
epileptic process. We report the first group study of children with fronta
l robe epilepsy. The results indicate that frontal lobe epilepsy produces s
ymptoms (deficits of planning, attention and motor dexterity) that are akin
to those found in frontal-lesioned adults. Similarly, like in adults, temp
oral lobe epilepsy produces memory impairment in children as well as behavi
oral and academic disturbances. Occipito-parietal lobe epilepsy is rare in
children and its effects still need to be specified. The second section dea
ls with the neuropsychological techniques used in presurgical evaluation. F
inally, the various neurosurgical procedures that are increasingly being us
ed as part of the arsenal of epilepsy treatment are described along with th
e neuropsychological findings that are associated with these interventions.
It can be concluded that the beneficial effects of epilepsy surgery (callo
sotomy, hemispherectomy, temporal and extra-temporal resections) by far out
weigh the few cognitive deficits that are occasionally reported following t
hese interventions.