Many people with epilepsy experience cognitive problems as a consequence of their epilepsy and its treatment. However, relatively few longitudinal studies have been conducted to investigate how these problems progress during the course of the disorder, particularly in those who are newly diagnosed. Fifty patients with newly diagnosed epilepsy were assessed using a comprehensive neuropsychological test battery before they started antiepileptic treatment and after a mean of 5years. At the 5-year follow-up, the majority of cognitive measures remained stable, although significant (but subtle) declines were noted for memory and psychomotor speed domains in 38% of people with epilepsy.