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Neuropsychology: Behavioural evaluation and intracarotid Amobarbital Procedure (IAP).

The impact of epilepsy on cognitive and emotion functioning has been widely documented 12,13. It is because of this very reason that clinical neuropsychologists, psychologists specialised in decoding the effect of changes in brain functioning on behaviours, are involved in the management of people with epilepsy. Neuropsychologists conduct comprehensive neuropsychological assessment for people with epilepsy for the understanding of their cognitive strengths and weaknesses and comparison of pre-and post-surgical cognitive functions. Neuropsychologists also assess the emotion status as adjustment difficulties are very common among people suffering from epilepsy that often exerts a negative effect on the academic, vocational and social lives of these people. With thorough understanding of the patients' cognitive status, behavioural alterations, personality characteristics, and adjustment difficulties, neuropsychologists play an important role in planning cognitive rehabilitation and facilitating psychosocial adjustment of people with epilepsy. In order to achieve the goal of assessing the cognitive and emotional status of people with epilepsy, a neuropsychological assessment is conducted. A basic neuropsychological assessment evaluates different cognitive functions, such as intellectual functioning, attention, language, perception and nonverbal functions, memory, and executive functions, in order to test the status of different brain regions. Assessment of emotion functioning is also one of the goals, given the adjustment difficulties presented by people with epilepsy. A thorough evaluation usually requires six to eight hours of direct contact between the examiner and the patient. By comparing an individual's scores to norms of similar age and educational level, an objective conclusion of cognitive functioning can be drawn. A cognitive profile illustrating the strengths and weaknesses as well as highly specific aspects of brain functions provides an objective baseline to which later assessments can be compared when patients are re-evaluated. There is considerable evidence indicating that the IQ (intelligence quotient) scores of individuals with epilepsy tend to be skew toward lower values 7. As the verbal IQ is highly correlated with school performance, it allows us to use educational achievement to estimate pre-morbid IQ and to detect cognitive decline in patients. The IQ scores can also be used as comparison with performance on specialised tasks to detect specific deficits. The Wechsler Adult Intelligence Scale is commonly used in Hong Kong to assess general intelligence. Attention Attention is a complex cognitive construct that includes the ability to respond to basic sensory stimulation, selectively attend to relevant stimuli while suppressing responses to irrelevant stimuli, and maintain focus on the environment and …