Frontal lobe seizures

Definition

What are frontal lobe seizures?

Frontal lobe seizures are a common form of epilepsy, a neurological disorder in which clusters of brain cells send abnormal signals and cause seizures. These types of seizures originate in the front of the brain.

Frontal lobe seizures may also be caused by abnormal brain tissue, infection, injury, stroke, tumors or other conditions.

Because the frontal lobe is large and has many important functions, frontal lobe seizures may produce a number of unusual symptoms that can appear to be related to a psychiatric problem or a sleep disorder.

Frontal lobe seizures often occur during sleep and may feature bicycle pedaling motions and pelvic thrusting. Some people scream profanities or laugh during frontal lobe seizures.

Medications usually can control frontal lobe seizures, but surgery or an electrical stimulation device may be options if anti-epileptic drugs aren’t effective.

How common are frontal lobe seizures?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of frontal lobe seizures?

The common symptoms of frontal lobe seizures are:

• Head and eye movement to one side
• Complete or partial unresponsiveness or difficulty speaking
• Explosive screams, including profanities, or laughter
• Abnormal body posturing, such as one arm extending while the other flexes, as if the person is posing like a fencer
• Repetitive movements, such as rocking, bicycle pedaling or pelvic thrusting

Frontal lobe seizures usually last less than 30 seconds and often occur during sleep. In some cases, recovery may be immediate.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes frontal lobe seizures?

Frontal lobe seizures, or frontal lobe epilepsy, may be caused by abnormalities — such as tumors, stroke, infection or traumatic injuries — in the brain’s frontal lobes.

Frontal lobe seizures are also associated with a rare inherited disorder called autosomal dominant nocturnal frontal lobe epilepsy. If one of your parents has this form of frontal lobe epilepsy, you have a 50 percent chance of inheriting this abnormal gene that causes this disorder and developing the disease yourself.

In about half of cases, however, the cause of frontal lobe epilepsy remains unknown.

Risk factors

What increases my risk for frontal lobe seizures?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How are frontal lobe seizures diagnosed?

Frontal lobe epilepsy can be difficult to diagnose because its symptoms may be mistaken for psychiatric problems or sleep disorders, such as night terrors. It has not been studied as much as some other types of epilepsy. It’s possible that some seizure effects found in the frontal lobe may be the result of seizures that begin in other parts of the brain.

Your doctor will first review your symptoms and medical history and give you a physical exam. Your physical may include a neurological exam, which will assess:

• Muscle strength
• Sensory skills
• Hearing and speech
• Vision
• Coordination and balance

Your doctor may suggest the following tests.

• Brain scans. Frontal lobe seizures can be caused by tumors, abnormal blood vessels or injuries. Brain imaging, usually an MRI, may reveal the source. An MRI uses radio waves and a powerful magnetic field to produce very detailed images of soft tissues such as the brain. To undergo an MRI scan, you must lie on a narrow pallet that slides into a long tube. The test often takes about an hour to complete. Some people may feel claustrophobic inside MRI machines, although the test itself is painless.
• Electroencephalogram (EEG). An EEG monitors the electrical activity in your brain via a series of electrodes attached to your scalp. EEGs are often helpful in diagnosing some types of epilepsy, but results may be normal in frontal lobe epilepsy.
• Video EEG. Video EEG is usually performed during an overnight stay at a hospital’s sleep clinic. Both a video camera and an EEG monitor run all night. Doctors can then match what physically occurs when you have a seizure with what appears on the EEG at the same time.

How are frontal lobe seizures treated?

Over the past decade, treatment options have increased for frontal lobe seizures. There are newer types of anti-seizure medications as well as a variety of surgical procedures that may help if medications don’t work.

Medications

All anti-seizure drugs seem to work equally well at controlling frontal lobe seizures, but not everyone becomes seizure-free on medication. Your doctor may try different types of anti-seizure drugs or have you take a combination of drugs to control your seizures. Researchers are continuing to look for new and more-effective medications.

Surgery

If your seizures can’t be controlled adequately with medications, your doctor may recommend surgery. In general, surgery for seizures that aren’t well-controlled by medication may be quite successful. Surgery involves pinpointing the areas of the brain where seizures occur.

Two newer imaging techniques — single-photon emission computerized tomography (SPECT) and subtraction ictal SPECT coregistered to MRI (SISCOM) — are very helpful at identifying the area generating seizures.

Another imaging technique, known as brain mapping, is commonly used before epilepsy surgery. Brain mapping involves implanting electrodes directly into an area of the brain and using electrical stimulation to determine whether that area has an important function, which would rule out surgery on that area. In addition, functional MRI (fMRI) is used to map the language area of the brain.

Surgery for epilepsy may involve:

• Removing the focal point. If your seizures always begin in one specific spot in your brain, removing that small portion of brain tissue may reduce or eliminate your seizures.
• Isolating the focal point. If the portion of the brain that’s causing seizures is too vital to remove, surgeons may make a series of cuts to help isolate that section of the brain. This prevents seizures from moving into other parts of the brain.
• Stimulating the vagus nerve. Vagus nerve stimulation involves implanting a device — similar to a cardiac pacemaker — to stimulate your vagus nerve. This procedure usually reduces the number of seizures people experience.
• Responding to a seizure. A responsive neurostimulator (RNS) is a newer type of implanted device. It is activated only when you begin to have a seizure, and it stops the seizure from occurring.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage frontal lobe seizures?

The following lifestyles and home remedies might help you cope with frontal lobe seizures:

Some seizures may be triggered by alcohol intake, smoking and especially lack of sleep. There is also evidence that severe stress can provoke seizures, and that seizures themselves can cause stress. Avoiding these triggers where possible may help improve seizure control.

If you have any questions, please consult with your doctor to better understand the best solution for you.