Frontal lobe epilepsy
Frontal lobe seizures are seizures that originate in the front of the brain, usually occur during sleep. There is a scream or laugh during a frontal lobe seizure.
Understanding Frontal lobe epilepsy - Diagnosisbook supporting video
Define frontal lobe epilepsy
Frontal lobe epilepsy is seizures that originate in the front of the brain. Seizure symptoms can vary depending on which part of the brain is involved. Frontal lobe epilepsy can have unusual symptoms that appear to be related to a psychiatric problem or sleep disorder.
Frontal lobe epilepsy often occurs during sleep. Some people scream or laugh during frontal lobe epilepsy.
In many cases of frontal lobe epilepsy, brain wave tests (electroencephalograms) do not show the altered characteristics of seizures originating elsewhere in the brain. Medication can often control frontal lobe epilepsy, but surgery is an option if antiepileptic drugs are not effective.
Frontal lobe epilepsy usually lasts less than 30 seconds and usually occurs during sleep. Signs and symptoms of frontal lobe epilepsy may include:
- Head movements and eye movements to the side.
- Complete or partial response or difficulty speaking.
- Shout or laugh.
- Abnormal body condition, such as an extended arm while flexing another body part.
- Repetitive motion.
See your doctor if you have signs or symptoms of frontal lobe epilepsy. Call emergency medical help if someone has a seizure that lasts more than five minutes.
Frontal lobe epilepsy can be caused by an abnormality such as a tumor, a vascular malformation, or an injury to the frontal lobe of the brain. An abnormal gene causes a rare genetic disorder on the chromosome that normally governs nocturnal frontal lobe epilepsy. If one of the parents has frontal lobe epilepsy, there is a 50 percent chance of inheriting the genes and developing the same disease.
However, in most cases, the cause of frontal lobe epilepsy remains unknown.
Frontal lobe epilepsy tends to be localized and can cause a dangerous condition called Status Epilepticus (SE), in which the activity lasts longer than usual. Seizures lasting more than five minutes should be considered a medical emergency.
The movements that occur in frontal lobe epilepsy sometimes cause injury from experiencing seizures.
Depending on the frequency and duration of the seizures, frontal lobe epilepsy can affect memory, motor skills, and other brain function. However, more research is needed.
Testing and diagnosis
Frontal lobe epilepsy can be difficult to diagnose because its symptoms can be confused with mental problems or sleep disorders (such as night terrors). Your doctor may recommend the following tests.
Brain scan: Frontal lobe epilepsy can be caused by a tumor, vascular malformation, or by trauma. Brain imaging, often an MRI, can reveal abnormalities. An MRI uses radio waves and a strong magnetic field to create detailed images of brain soft tissues. This test usually takes about an hour to complete. Some people may feel claustrophobic inside the MRI machine, even though the test is painless.
Electroencephalogram (EEG): The EEG monitors electrical activity in the brain through a series of electrodes attached to the scalp. EEG is often helpful in diagnosing some types of seizures but may be normal in frontal lobe seizures.
EEG video: EEG video is usually taken during an overnight stay in the hospital. Both video cameras and EEGs were monitored all night. Doctors can then match the seizure symptoms with what appears on the EEG at the time. But video EEG is expensive and may not be available.
Treatments and drugs
Over the past decade, treatment options for frontal lobe epilepsy have increased. There are many new anti-seizure medications and a variety of surgical procedures that can help if medications aren't working.
Medicine: All antiepileptic drugs seem to work equally well, controlling frontal lobe epilepsy, but not everyone becomes free of them. Your doctor may try anti-seizure medications or a combination of medications to control seizures.
Surgery: If seizures cannot be controlled adequately with medication, your doctor may recommend surgery. Surgery involves locating the areas of the brain where seizures occur. Two newer imaging techniques - photon emission tomography (SPECT) and (SISCOM) - are more accurate at identifying the area, but are not yet widely available.
An imaging technique called brain mapping is often used before seizures surgery. Brain mapping involves implanting electrodes directly into an area of the brain and using electrical stimulation to determine if that area has a vital function, which can surgically remove that area.
Seizures surgery may include:
Remove the focus: If seizures always start at a specific location in the brain, removing a small portion of brain tissue can reduce or eliminate seizures.
Isolate the focal point: If the part of the brain that is causing the seizure is too important to remove, the surgeon may make a series of cuts to help isolate the part of the brain. This stops the seizure from moving into other parts of the brain.
Stimulation of the vagus nerve: Another option for surgery is to implant a device similar to a pacemaker to stimulate the vagus nerve. The device is inserted under the skin of the chest, and the wire is threaded under the skin and then wrapped around the vagus nerve in the neck. This procedure usually reduces the number of seizures.
Lifestyle and remedies
Some seizures can be triggered by excessive alcohol intake or lack of sleep. Avoiding stimuli can help improve seizure control.
Coping and supporting
People with seizures surgery may be embarrassed or frustrated by their problems. Frontal lobe epilepsy surgery can be particularly embarrassing because of sometimes vocal features or sexual movements.
Family members can encourage a positive outlook and avoid blaming or resenting the person having the seizure. Counseling services and seizures surgery support groups can assist families in learning to cope.