社会认知是个体识别他人情绪与意图的核心能力，依赖于一个高度协同的社会脑网络（social brain network，SBN），包括梭状回、杏仁核、内侧前额叶等关键脑区。癫痫作为一种网络性疾病，不仅引起发作症状，更通过致痫灶直接侵犯或异常放电远程传播，破坏SBN结构与功能，导致患者出现情绪识别困难、心理理论缺损、共情障碍及社会决策异常等社会认知功能障碍。儿童及青少年癫痫患者因脑网络尚在发育中，更易出现社会认知发展偏离。本文系统阐述癫痫中SBN的神经机制、临床表现及其在儿童青少年中的发展特点，并提出从评估到干预的临床转化路径，强调应结合神经影像、神经心理测评与多模态康复策略，推动癫痫诊疗从控制发作向改善社会功能的模式转变。

Social cognition is a core ability that enables individuals to recognize others' emotions and intentions and relies on a highly coordinated social brain network (SBN), which includes key brain regions such as the fusiform gyrus, amygdala, and medial prefrontal cortex. As a network disorder, epilepsy not only causes seizure manifestations but also disrupts the structure and function of the SBN through direct involvement of epileptogenic foci or the remote propagation of abnormal discharges, leading to social cognitive impairments such as difficulties in emotion recognition, deficits in theory of mind, impaired empathy, and abnormalities in social decision-making. Children and adolescents with epilepsy are particularly vulnerable to deviations in social cognitive development because their brain networks are still undergoing maturation. This review systematically elaborates on the neural underpinnings and clinical manifestations of the SBN in epilepsy, as well as its developmental characteristics in children and adolescents, and proposes a clinically translatable pathway from assessment to intervention. Furthermore, it emphasizes the integration of neuroimaging, neuropsychological assessment, and multimodal rehabilitation strategies to promote a paradigm shift in epilepsy management from seizure control to the improvement of social functioning.