We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe.

2nd Faculty of Medicine Motol University Hospital Charles University Prague Prague Czech Republic

Alexandu Obregia Clinical Psychiatric Hospital Pediatric Neurology Clinic Bucharest Romania

Aristotle University of Thessaloniki Thessaloniki Greece

Claudio Munari Epilepsy Surgery Center Niguarda Hospital Milan Italy

Clinic of Child Neurology St Naum University Hospital of Neurology and Psychiatry Sofia Bulgaria

Danish Epilepsy Center Filadelfia University of Copenhagen EEMA Dianalund Denmark

Department of Child Neurology Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands

Department of Clinical Neuroscience and Rehabilitation Institute of Neuroscience and Physiology Sahlgrenska University Hospital The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden

Department of Clinical Neurosciences CHUV Lausanne Switzerland

Department of Clinical Neurosciences Pediatric Neurology Clinic Carol Davila University of Medicine Bucharest Romania

Department of Epileptology Medical Center University of Bonn Bonn Germany

Department of Neurology and Neurosurgery of the Russian National Research Medical University Moscow Russia

Department of Neurology Center for Refractory Epilepsy University Hospital Ghent Ghent Belgium

Department of Neurology Christian Doppler Klinik Paracelsus Medical University Salzburg Salzburg Austria

Department of Neurology Epilepsy Program Hospital Ruber International Madrid Spain

Department of Neurology Vilnius University Hospital Santariškių klinikos Vilnius Lithuania

Department of Neurology Zagreb Epilepsy Center University Hospital Zagreb Croatia

Department of Pediatric Psychology Sector of Neuropsychology University Medical Center Utrecht Utrecht The Netherlands

Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Division of Clinical Electro Neurophysiology Department of Neurology Cerrahpaşa Medical Faculty Istanbul University Istanbul Turkey

EEG and Epilepsy Unit Hospital of Geneva and Functional Neurology and Neurosurgery Program University Hospitals of Geneva and Lausanne Geneva Switzerland

Epilepsiezentrum Kork Kehl Kork Germany

Epilepsy Center Neurocenter Kuopio University Hospital Kuopio Finland

Epilepsy Institute IDEE Lyon France

Faculty of Medicine Clinic of Neurology and Neurosurgery Vilnius University Vilnius Lithuania

Moscow Research and Clinical Center for Neuropsychiatry Moscow Russia

National Center for Epilepsy Oslo University Hospital Oslo Norway

National Institute of Clinical Neurosciences Budapest Hungary

School of Medicine University of Eastern Finland Kuopio Finland

University College London Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust London United Kingdom

University Departement of Neurology Strasbourg France

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