[Epilepsy and learning: a neuropsychological approach].

INTRODUCTION: The quality of life of an epileptic patient largely depends on the interplay of the control of the convulsive crises and the degree to which higher mental functions are affected. Some types of epilepsy lead to mental retardation during development and with others the basic cerebral mechanisms for processing data are damaged and this may lead to transient or permanent cogniscitive deterioration. DEVELOPMENT: There are certain important clinical factors such as the site of the discharge regarding the lobe, hemisphere, type of cerebral area involved and the age of the patient. We describe the clinical features of each type of epilepsy with respect to focal or generalized involvement. The subclinical effects of continuous discharges affects processing in the areas involved and therefore intellectual function, thus leading to a secondary learning disorder. The neuropsychological tests used in investigation of higher cerebral functions in epilepsy include, in general, tests to assess speed of processing, attention, memory, reasoning and visuospacial ability and frontal executive functions.
CONCLUSIONS: These tests should be sufficiently sensitive so as to detect minimal changes in the state of the illness, the time elapsed and the medication given. Anticonvulsant drugs may themselves cause changes in mental functions. There may often be mixed neurocognitive behaviour depending on the drug used. There may also be transient cognitive deterioration.