Impairment in attention in rolandic epilepsy (RE) was evaluated in 14 studies published between 1990 and 2006, in a study at Columbia University Medical Center and Queens College of the City University of New York, NY. Sample sizes ranged from 9 to 44 subjects. A cross-sectional design was used in 7 studies (6 having active EEG abnormalities and 1 with EEG remission). Longitudinal studies were employed in 7 publications (EEGs were all abnormal and patients were followed until normalized). Twelve studios measured the alerting network, according to the Posner model of attention, 11 studies the orienting network, and 8 the executive network. Impairments in all attention networks were demonstrated by controlled studies but not by uncontrolled studies. At follow-up, when the EEG had normalized, attention impairments had almost completely resolved. The neuroanatomically based model of attention such as Posner’s that targets alerting, orienting, and executive functions, is a reliable method of assessment of attention in children with epilepsy. [1]

COMMENT. Children with rolandic epilepsy are predisposed to impairments of attention that resolve with remission of EEG centrotemporal spikes. Attention impairment in RE is correlated not with seizures but with EEG epileptiform discharges. Children with RE should be monitored for attention, language, and learning disorders. Rolandic spikes may aggravate the course of ADHD and predispose to increased impulsivity. [2]