Research studies over almost three decades have explored the psychological impact of epilepsy and its treatment. A major research focus is the cognitive impact of temporal lobe surgery. Memory decline can be a serious adverse outcome. Our research has measured the nature and extent of memory and other cognitive changes post-operatively and has sought to identify predictive factors that can contribute to the clinical decision making process. We have followed more than 700 patients up to one year post-operatively and have recently completed a longer term follow up ( range 5-15  years) on  a surgical cohort. In an ongoing prospective study of surgical cases we are assesing memory and executive skills via standard clinical tests and fMRI paradigms with the aim of assessing different patterns of cognitive change and the relationship to functional and structural brain connectivity. We have recently completed a pilot study assessing the benefit of memory rehabilitation and its potential role in offsetting declines observed following temporal lobe surgery and in the future we will be widening the memory training programe to non-surgical cases. In collaboration with researchers at the Institute of Psychiatry we have been exploring the neuroanatomical basis of frontal lobe epilepsy and idiopathic generalised epilepsy utilising clinical neuropsychological measures and fMRI tests of decision making, working memory and impulse control. The cognitive impact of antiepileptic drug tretment is a long standing research interest. A study has just ended ascertaining the potential impact of phenobarbital on cognition in previously untreated or inadequately treated patients with convulsive seizures in a large cohort in rural China. Newer developments are underway cognitive phenotypes in epilepsy syndromes and in non epilepsy patients with a variety of genetic mutations.