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Bulletin vol. 28 no. 1 | 27 education), seizure related variables (age of onset, duration, and number of AEDs) were significant predictors in several domains. It is important to note that the TLE sample was still quite young and many years away from the expected impact of age on cognition. Given the heterogeneity of cognitive profiles shown by these participants, we used cluster analysis to determine if distinct cognitive phenotypes could be found. Three distinct cognitive profiles were identified in the TLE group: Cluster 1 consisted of 47% of the TLE subjects who showed minimal cognitive difference to the healthy controls, Cluster 2 consisted of 27% of the sample and was characterized by predominantly memory performance, and Cluster 3 subjects consisting of 29% of the TLE subjects showed poor performance across all cognitive domains. When these three cluster groups were examined at the four year evaluation, different patterns of prospective change were evident. Cluster 3 subjects who were the most impaired at baseline also showed the greatest four-year cognitive decline whereas the best cognitive course was seen for Cluster 1 subjects. Cluster 3 subjects also showed greater volume abnormality at baseline than the other two groups. Overall, the best volumetric predictor of cognitive change over the four year interval was increased ventricular enlargement (Hermann et al., 2007). Summary We have provided a very brief overview of current neuropsychological findings on aging and cognition and brain structure in chronic intractable epilepsy. Although many pieces still remain to be clarified, there is growing support for a life span perspective. In this context, childhood onset epilepsy is associated with abnormalities in cognition and brain structure that are apparent in early adulthood. Recent findings from our group indicate that the neurobiological substrate is compromised at the time of epilepsy diagnosis and quite possibly earlier (Hermann et al., 2008). It is quite possible that these abnormalities are compounded if education and social opportunities are negatively impacted in subsequent years. For these people, the normal age-related changes expected in cognition and brain structure may serve as an additional "insult". An important objective of the lifespan perspective is to achieve a better understanding of what happens as these people get older. Neuropsychologists are well suited to this goal. References Baxendale, S.Heany, D., Thompson, PJ., Duncan, JS (2010). Cognitiove consequences of childhood-onset temporal lobe epilepsy across the adult lifespan. Neurology, 75: 705-711. Dodrill, CB (2004).\. Neuropsychological effects of seizures. Epilepsy and Behavior, 5, (suppl 1), 21-24.. Griffith, HR., Martin, RC, Bambara, Marson, DC, and Faught, E. (2006). Older adults with epilepsy demonstrate cognitive impairments compared with patients with amnestic mild cognitive impairment. Epilepsy and Behavior8, 161-168. Helmstaedter, C., Elger, C. (2009). Chronic temporal lobe epilepsy: a neurodevelopmental or progressively dementing disease. Brain, 132: 2822- 2830. Hermann, B., Seidenberg M., Bell B., Rutecki P., Sheth R., Ruggles K., Wendt G., O'Leary D. and Magnotta V. (2002). The neurodevelopmental impact of childhood-onset temporal lobe epilepsy on brain structure and function. Epilepsia 43(9): 1062-71. PMID: 12199732. Hermann, B., Seidenberg M., Dow C., Jones J., Rutecki P., Bhattacharya A. and Bell B. (2006). Cognitive prognosis in chronic temporal lobe epilepsy. Annals of Neurology 60(1): 80-7. PMID: 16802302. Hermann, B., Seidenberg, M., Lee, E.J., Chan, F., Rutecki, P (2007). Taxonomy of cognition in temporal lobe epilepsy. Journal of the International Neuropsychological Society ,13:12-20. Hermann, B., Seidenberg, M., Sagar, M., Carlsson, C., Gidal, B., Sheth, R., Rutecki, P., Asthana, S. (2007). Growing old with epilepsy: the neglected issue of cognitive and brain health in aging and elder persons with chronic epilepsy. Epilepsia, Hermann, B., Jones, J., Sheth, R., Kohen, M., Becker, T., Fine, J., Allen, C. & Seidenebrg, M. (2008). Growing up with epilepsy: A two year investigationof cognitive development in children with new onset epilepsy. Epilepsia, 1-8. Lowenstein, DH (2010). Epilepsy and trauma. Neurology, 75 (3), 202-203. Oyegbile, T. O., Dow C., Jones J., Bell B., Rutecki P., Sheth R., Seidenberg M. and Hermann B. P. (2004). The nature and course of neuropsychological morbidity in chronic temporal lobe epilepsy. Neurology 62(10): 1736-42. PMID: 15159470. Pulsipher, D. Seidenberg, M., Morton, J., Geary, E., Parrish, J., Hermann, B. (2007). MRI volume loss of subcortical structures in unilateral temporal lobe epilepsy Roberson,ED, Omotola, A., Hope, Martin, RC, Schmidt, D. (2011). Geriatric epilepsy: Important issues and trends in future research. Epilepsy and Behavior,22,103-111. Seidenberg, M., Hermann, B. (2012).A lifespan perspective of cognition in epilepsy. In Lifespan Developmental Neuropsychology (edited by Donders, J., & Hunter. S.J.), 371-378. Seidenberg, M., Pulsipher, D., Hermann, B. (2007). Cognitive progression in epilepsy. Neuropsychological Review, 17, (4), 445-454. Bruce Hermann is Professor in the Department of Neurology and Director the Charles Matthews Neuropsychology Lab of the University of Wisconsin School of Medicine and Public Health. Michael Seidenberg received his Ph.D in psychology in 1978 from the University of Virginia. Completed post- doctoral training in clinical neuropsychology at the Highlands Epilepsy Center at the University of Virginia. Currently, Professor of Psychology at Rosalind Franklin University of Medicine and Science.