Neuropsychology: traditional and new methods of investigation

The neuropsychological assessment is an integral part of the clinical investigation of patients suffering from epilepsy. The aim of the evaluation is to determine disease-related and treatment-related effects on cognition and behavior in order to orient therapeutic interventions, by taking into account the compensatory mechanisms that are available to the patient. Examples of the tests best illustrating the classical neuropsychological protocol are presented. Neuropsychology also plays an important role in the assessment of language lateralization in patients slated for epilepsy surgery. Traditionally, this has been achieved by means of the rather invasive Wada procedure. However, with the advent of new neuroimaging techniques, this procedure is gradually being replaced by minimally invasive or noninvasive methods, such as functional magnetic resonance imaging, positron emission tomography, and optical imaging. In the present paper, we discuss some of the newer techniques that are available to the neuropsychologist for the study of the impact of epilepsy on cerebral functioning.