ABSTRACT
This chapter presents evidence for cognitive network dysfunction in epilepsy, emphasizing seizure-induced neuroplasticity, and its broad effects on cognition and brain network organization. It presents data from functional imaging and other sources, demonstrating that even focal epilepsies can induce more widespread neuropsychological changes than originally thought. The chapter briefly discusses models of network organization in the setting of seizures, noting how these help explain the complex nonfocal deficit patterns that are often observed. It examines the changing algorithm for presurgical assessments in epilepsy. Neuropsychological deficits within the episodic memory domain are well established in patients with mesial temporal lobe epilepsy (MTLE). Such impairments can be logically correlated with underlying medial temporal lobe pathology. However, patients with focal, lesional TLE have consistently demonstrated neurocognitive impairments in intelligence, language, visuospatial, executive, or motor function—impairments that cannot be solely explained by the underlying focal mesial neuropathology.
