What are executive functions?

Neurologists and neuropsychologists use the term "executive functions" to describe a set of complex behaviors that are necessary for a person to attain goals and adapt to changing environmental demands. These functions are thought to have a supervisory ("executive") relationship over other cognitive functions, including attention, memory, and perception.

Executive functions include a set of abilities that are necessary to organize the performance of these other cognitive functions, to make changes when necessary, and essentially to "run the show." They directly involve our ability to have insight into our own behavior and awareness of its effects.

Executive functions are often thought of as representing the highest levels of human mental activity, including consciousness and the ability to exercise judgment and free will. Some consider these abilities to be among the main factors separating humans from other animals.

How are they connected to epilepsy?

Many people with epilepsy are told that they have impairments in executive functions. Biological, medical, and psychosocial factors may interact to produce these difficulties. The effect of brain disorders on specific cognitive activities can cause the kinds of behavior that are symptomatic of problems with executive functions. For instance, these individuals may be seen as either more apathetic or more impulsive than others. In many cases, they are described as "not getting the point" of discussions and other social activities. Many consider them difficult to control. Sometimes these disturbances are associated with a neurological or psychiatric condition.

As with other cognitive activities, the level of executive functioning of a person with epilepsy will vary depending on factors that include the severity of the underlying brain disorder, how well the seizures are controlled, and the type or dose of medication that is being used.