Objective: Chronic epilepsy is associated with significant co-morbidities that are often more disabling than the seizure itself. Children with epilepsy often present with neuropsychiatric issues and cognitive impairments (memory, speed of processing and attention deficits) despite having normal global intellectual functioning. These impairments affect academic performance and overall quality of life yet remain unacknowledged and unaddressed.

The objective of the study was to examine the prevalence and spectrum of cognitive, mood, behavioural issues and academic difficulties in a group of children with chronic epilepsy in a tertiary hospital epilepsy clinic.

Methods: Retrospective data analysis of 30 children with focal epilepsy with normal intelligence underwent standardised, domain specific neuropsychological evaluation. Cognitive impairments as per the test score percentiles; mood, behaviour rating as per scales and parent report and academic difficulties as per the grades and teacher report were analysed.

Results: The mean duration of seizures was 5.64 years and the mean general intelligence (IQ) was 93.6. 80% had mood and behaviour difficulties (irritability, anger outbursts, oppositional defiant behaviour). 43% had academic challenges and 40% presented with cognitive complaints. On objective testing impairments were seen in executive functioning (73%), attention (>50%), and speed of processing (50%).

Conclusions: Early identification, monitoring, and appropriate intervention and rehabilitation for neuropsychological problems are required. Long-term risk of academic underperformance exists despite normal global intelligence. This study underscores an urgent need for psycho-education and awareness programmes for parents, teachers and health professionals to plan effective neuropsychological rehabilitation.