Social cognition allows us to elaborate mental representations of social relationships and use them appropriately in a social environment. One of its main attributes is the so-called Theory of Mind (ToM), which consists of the ability to attribute beliefs, intentions, emotions, and feelings to self and others. Investigating social cognition may help understand the poor social outcome often experienced by persons with Idiopathic
Generalized Epilepsies (
IGE), who otherwise present with normal intelligence. In recent years, several studies have addressed social cognition in subjects with
focal epilepsies, while literature on social cognition in
IGE is scarce, and findings are often conflicting. Some studies on samples of patients with mixed
IGE showed difficulties in emotion attribution tasks, which were not replicated in a homogeneous population of patients with
Juvenile Myoclonic Epilepsy alone. Impairment of higher order social skills, such as those assessed by Strange Stories Test and Faux Pas Tasks, were consistently found by different studies on mixed
IGE, suggesting that this may be a more distinctive
IGE-associated trait, irrespective of the specific syndrome subtype. Though an interplay between social cognition and executive functions (EF) was suggested by several authors, and their simultaneous impairment was shown in several
epilepsy syndromes including
IGE, no formal correlations among the two domains were identified in most studies. People with
IGE exhibit subtle brain structural alterations in areas potentially involved in sociocognitive functional networks, including mesial prefrontal and temporoparietal cortices, which may relate to impairment in social cognition. Heterogeneity in patient samples, mostly consisting of groups with mixed
IGE, and lack of analyses in specific
IGE subsyndromes, represent evident limitations of the current literature. Larger studies, focusing on specific subsyndromes and implementing standardized test batteries, will improve our understanding of sociocognitive processing in
IGE. Concomitant high-resolution structural and functional neuroimaging may aid the identification of its neural correlates. This article is part of the Special Issue "
Epilepsy and social cognition across the lifespan".