Epilepsy, which is defined by a pattern of recurring seizures, comprises an array of diseases and syndromes within an evolving classification framework. The cardinal feature of epilepsy is the electroclinical event, an anomalous behavior or sensory alteration that correlates with abnormal electrophysiological activity in the brain. Clinical manifestations of childhood epilepsy are broad, ranging from fleeting reductions of consciousness, to simple sensory and motor events, to complex behaviors and disruptions of higher-level cognition. Electrophysiological events associated with seizures also vary in form and localization.

Cognition in childhood epilepsy is influenced by several factors, including: (1) underlying genetic, metabolic, and neuropathologic processes that give rise to epileptic events, (2) transient event-related neurophysiological disruptions, (3) neuronal injury caused by epileptic events leading to progressive neurologic and cognitive deterioration, and (4) adverse effects of antiepileptic drugs (AEDs). Environmental and disease factors such as age of onset, seizure frequency, and epilepsy type or syndrome have also been associated with cognitive outcome in childhood epilepsy. In light of this heterogeneity, the failure to identify a “signature profile” of neuropsychological impairment in childhood epilepsy is not surprising. However, many forms of childhood epilepsy are associated with disruptions of behavior or cognition that are potentially indicative of EdF.