BackgroundEpilepsy affects from 0.5 to 1% of children worldwide and has a cognitive impact on the patient.ObjectiveTo assess cognitive characteristics in pediatric patients diagnosed with epilepsy.Material and methodsAnalytical, cross-sectional study of patients with epilepsy aged 6 to 16 years in a tertiary hospital in Puebla, Mexico. Type of epilepsy, evolution, treatment, and school performance were evaluated. The Wechsler Intelligence Scale IV was used for cognitive characteristics. Mann-Whitney U and phi coefficients were used. It was considered statistically significant a p < 0.05.Results95 patients were included, 61.1% were male. Mean: age 11.16 years (± 2.5), school performance 7.8 (± 0.99), time of development: 2.4 years (± 1.4). They were schoolchildren aged 6-11 years (36.8%) and adolescents aged 12-16 years (63.2%); 79% had generalized epilepsy; 93.6% were treated with monotherapy (47.3% with magnesium valproate). The mean intellectual quotient was 90.3 (± 10.02), decreased in 12 patients (12.6%). Working memory was the most commonly affected domain (31.6%), mostly in adolescents with 40% (p = 0.021). Perceptual reasoning and working memory were significantly correlated with developmental time (phi = 0.17, p = 0.04 and phi = 0.49, p < 0.001, respectively).ConclusionsWorking memory was the most affected cognitive characteristic, especially in adolescents. Working memory and perceptual reasoning were affected by time of development.