The relation of laterality of the epileptogenic focus to cognition and attention in 43 unmedicated children, mean age 10 years, with benign rolandic epilepsy of childhood was assessed at Clinica Neurologica Universita, Perugia, Italy. Children with right sided or bilateral paroxysmal foci scored worse on a figure cancellation task, whereas those with left-sided foci performed as well as controls. The task measures attentive processes and visuospatial orientation. 
COMMENT. Attentional difficulties in children with benign rolandic epilepsy are related to right hemisphere dysfunction and impaired visuospatial processing. The data did not support an hypothesis of left spatial neglect. The laterality of the epileptic focus is linked to the type of cognitive deficit. Left hemisphere dysfunction affects language-related abilities. Attentional disorders in epileptic children can be explained by paroxysmal activity, and is independent of any effect of antiepileptic drugs.