Frontal Lobe Epilepsy

Frontal lobe epilepsy is the second most common form of partial seizure epilepsy, after temporal lobe epilepsy. This type of epilepsy is characterized by abnormal brain activity in the frontal lobe that causes seizures. The frontal lobe is the portion of the brain located at the front of the head. This area is associated with:

• Behavior and emotions
• Language
• Memory
• Movement
• Planning
• Problem solving.

Frontal lobe seizures can be either simple partial or complex partial seizures. This type of seizure can be quite startling to onlookers, and may be mistaken for a psychiatric disorder.

What Causes Frontal Lobe Epilepsy?

Frontal lobe epilepsy is a symptomatic partial epilepsy syndrome, which means that there's often an obvious cause for the disorder. In many cases, however, this cause is not clear. In some cases, frontal lobe seizures are the result of a:

• Brain tumor
• Malformation in the brain
• Severe head injury.

A rare form of the syndrome, known as "autosomal dominant nocturnal frontal lobe epilepsy," is inherited.

What Does Frontal Lobe Epilepsy Look Like?

Frontal lobe seizures can be either simple partial seizures (the individual remains conscious) or complex partial seizures (the individual loses consciousness). Because the functions of the frontal lobe are so varied, seizure symptoms will depend on where the seizures originate. Symptoms of frontal lobe seizures may include:

• Inability to speak clearly
• Making "bicycle" movements with the legs
• Muscle weakness
• Sexually suggestive behavior
• Stiff arms
• Strange, inexplicable body movements (i.e. jerking muscles, frozen limbs, etc.)
• Sudden laughing, screaming or swearing
• Turning the head to one side.

Frontal lobe epilepsy can also be identified by several other characteristic features. Frontal lobe seizures, for example, generally:

• Are less likely to be followed by confusion, as with temporal lobe seizures
• Begin suddenly and are very brief (less than one minute)
• Tend to occur at night
• Tend to occur in clusters (status epilepticus, a serious condition involving continuous or successive seizures, can develop).

Although not always the case, frontal lobe seizures often develop into generalized tonic-clonic (convulsive) seizures quite quickly. This rapid transition can sometimes make frontal lobe seizures hard to identify.

What's the Prognosis for Frontal Lobe Epilepsy?

In general, frontal lobe seizures respond well to anti-epileptic medication. Some individuals with inherited frontal lobe epilepsy may eventually become seizure-free. In cases that the disorder has developed as a result of a permanent brain injury or malformation, medication may not be effective. In such cases, vagus nerve stimulation or brain surgery may work.

The vagus nerve runs from the brain to the carotid artery. Vagus nerve stimulation involves surgically implanting a device in the body that will stimulate the vagus nerve and help to control seizures.

If there is a single, affected area in the brain responsible for frontal lobe epilepsy, surgery may be required to remove that area. If the area is successfully removed, frontal lobe seizures will likely disappear, but permanent neuropsychological effects may occur.

Resources

Donner, E. J. et al. (2006). Other epilepsy syndromes. Retrieved March 24, 2010, from http://www.aboutkidshealth.ca/Epilepsy/Other-Epilepsy-Syndromes.aspx?articleID=6988