Neuropsychological Testing

Temple Medical Building,
60 Temple Street,
New Haven, CT

An important part of the overall care and treatment of patients includes neuropsychological testing. The specifics of neuropsychological testing are different for children and adults, but both share the common goal of helping doctors, patients, and their families understand how epilepsy may affect cognitive functions such as memory, language, and attention. Neuropsychological testing also includes an assessment of how epilepsy and related issues can affect a person's emotional function.

Neuropsychological Testing in Children

The neuropsychological evaluation of a child with epilepsy can help us to understand how seizures influence brain development from a functional point of view. While the other tests (EEG and imaging) can help understand the underlying neurological cause and pinpoint the origin of the seizures, they do not provide information about how seizures affect a child's behavior and learning abilities. Neuropsychological testing can provide this information and assist the Physician team in managing the seizures (for example, helping to localize seizures, understand side effects of medication, and help establish risk-benefit profiles of treatment options). The testing can also be an important tool to help school personnel understand how seizures affect learning in unique ways that differ from other types of learning problems such as dyslexia or ADHD.

What Does the Neuropsychological Evaluation Consist Of?

The neuropsychological evaluation typically includes administration of standardized tests to determine a child's level of ability in the following areas:

  • General intellectual function (IQ testing)
  • Visual perception and nonverbal information processing
  • Speech and language development
  • Attention
  • Processing speed
  • Learning and memory
  • Executive function (skills such as planning, organization, self-monitoring, ability to shift thinking patterns flexibly, and inhibition)
  • Screening of achievement (reading, spelling, math)
  • Screening of motor skills (sensorimotor integration and manual dexterity)
  • Behavioral and emotional development

The typical battery includes direct, face-to-face testing time of about 4 hours for most children, although this can vary depending on a child's age and skill level. After the evaluation is completed, a written summary and interpretation of the results is prepared for the treatment team and the results shared with the parents. If the results indicate the presence of any type of learning problems, the results can also be shared with the school team assigned to working with that child.

Adult Neuropsychological Examination

The majority of individuals with epilepsy do not have significant problems with functioning in everyday life. However, there are some instances where seizures can greatly affect function, particularly when seizures are hard to control with medications. The neuropsychological examination of adult patients can help to identify areas of difficulty in cognitive function that are related to the parts of the brain involved in seizure onset, medication effects, and emotional/psychological issues that may come up.

Neuropsychological testing can be done in an outpatient setting, or may be performed during a hospital admission for a comprehensive diagnostic evaluation that also includes EEG-Video monitoring and imaging studies. The adult neuropsychological testing takes approximately 5-6 hours but can vary depending on individual factors such as fatigue, prior testing experience, and the types of difficulty a patient may have with their cognitive abilities. The domains that are tested include:

  • General intellectual function (IQ testing)
  • Visual perception and nonverbal information processing
  • Speech and language development
  • Attention
  • Processing speed
  • Learning and memory
  • Executive function (skills such as planning, organization, self-monitoring, ability to shift thinking patterns flexibly, and inhibition)
  • Screening of achievement (reading, spelling, math)
  • Screening of motor skills (sensorimotor integration and manual dexterity)
  • Psychological function (emotional and personality disorders)

If a patient is considering surgery to treat their seizures, the results of the neuropsychological testing are presented in a multidisciplinary conference to the treatment team, who will incorporate the results of the testing into their overall assessment. The neuropsychological testing can specifically add to the localization of seizure onset, and to help determine if there are any risks of further cognitive impairment that might be associated with epilepsy surgery.