In contrast to short-term cognitive outcomes, long-term cognitive outcomes (over 5 years) has been scarcely assessed so far. Yet, predicting long-term outcomes at any time point of the epilepsy, from initial diagnosis, to medically intractability is very important for therapeutic decision-making, patient information, and orientation. Assessing long-term cognitive outcomes in patients with epilepsy would ideally require longitudinal studies and a comparison with a healthy controls group. This issue has been addressed extensively, but with controversial results. However, there is a general consensus about the fact that cognitive outcome is not the same in all groups of patients with epilepsy. Possible prognostic factors include age at onset, duration of epilepsy, syndrome and etiology, seizure outcome and therapeutics. The multiplicity of factors makes it very difficult to assess their relative weight in individuals. Although long-term cognitive outcome studies are scarce, this issue has been specifically studied in newly diagnosed epilepsies and in focal drug-resistant epilepsies. In the first clinical setting, i.e. newly diagnosed epilepsy, it appears that cognitive deficits are already present at epilepsy onset in a significant proportion of patients but seem to remain stable over time. In focal drug-resistant epilepsies, cognitive deficits (mainly verbal memory) were generally shown to remain stable provided that seizures were controlled either by medication or by surgery. Beyond the possible correlation between seizure and cognitive outcome, no causal link however has been demonstrated between these two important outcomes.

与短期认知结果相反，到目前为止，几乎没有评估长期认知结果（超过5年）。然而，对于癫痫发作的任何时间点（从最初的诊断到医学上的可治疗性）的预测，长期结果对于治疗决策，患者信息和定向非常重要。理想情况下，评估癫痫患者的长期认知结局需要进行纵向研究，并与健康对照组进行比较。这个问题已得到广泛解决，但结果却颇具争议。但是，对于所有癫痫患者的认知结果并不相同这一事实已达成普遍共识。可能的预后因素包括发病年龄，癫痫持续时间，综合征和病因，癫痫发作的结局和治疗方法。多种因素使得很难评估他们在个人中的相对体重。尽管缺乏长期的认知结果研究，但已在新诊断的癫痫病和局灶性耐药性癫痫病中专门研究了此问题。在第一个临床环境中，即新诊断的癫痫病中，似乎在癫痫发作时已经有相当多的患者出现了认知缺陷，但随着时间的推移似乎保持稳定。在局灶性耐药性癫痫病中，只要通过药物或手术控制癫痫发作，通常就可以证明认知缺陷（主要是言语记忆）保持稳定。除了癫痫发作与认知结果之间可能存在的相关性外，这两个重要结果之间尚无因果关系。