Neuropsychological assessment for temporal lobe epilepsy surgery

Neuropsychological assessment consists of a comprehensive evaluation of cog nitive functioning and most often some evaluation of motor skills and senso ry status also. Cognitive functions sampled typically include "intelligence " (IQ tests), attention, language skills, visuospatial abilities, "executiv e skills" and other abilities associated with frontal-lobe function, and le arning and memory. Thus, the assessment samples vary widely among a variety of functions, providing a comprehensive picture of an individual's strengt hs and weaknesses. The resulting pattern points to the probable site of epi leptic focus. Neuropsychological findings also serve to predict the risk fo r postsurgical cognitive decline and, when performance before and after ope ration is compared, they provide data on the impact of surgery upon cogniti ve functioning. Comprehensive evaluation of learning and memory is particul arly important in this context, because of the frequency of temporal lobe e pilepsy and the prominence of memory dysfunction associated with it. In add ition, patients slated for elective surgery may also undergo an intracaroti d amobarbital procedure (IAP), which is performed to determine the side of cerebral dominance for language and to test the memory capabilities of each hemisphere alone. All of these specialized neuropsychological tools are di scussed in this paper.