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Frontal Lobe Seizures

The brain contains two frontal lobes located at the front of the brain. The frontal lobes are the largest of all the lobes and, as such, are responsible for a vast array of functions. Just a few of these functions include muscle control and movement, cognitive thinking, decision-making, language production, personality, and behaviour.

As its name implies, a frontal lobe seizure is a seizure that originates in one of the frontal lobes of the brain. Frontal lobe seizures often occur at night. They can lead to personality changes and sleep disturbances. Consequently, frontal lobe seizures are sometimes incorrectly diagnosed as a psychiatric condition or sleep disorder.

Symptoms

For some, the first symptom of a frontal lobe seizure is an aura. An aura takes place anywhere from several seconds to an hour before the seizure occurs. Because of this, an aura is a useful warning that a seizure is impending.

Auras can be quite diverse and hard to describe. Examples of common auras are listed below:

  • Sudden feeling of joy, fear, panic, or anxiety
  • Recalled memory
  • Flashing lights, swirling colours, or other visual hallucination
  • Unusual buzzing sound or other auditory hallucination
  • Unusual smell or taste
  • Sense of déjà vu
  • Rising sensation in the belly
  • Feeling of butterflies with nausea

A frontal lobe seizure generally lasts less than 30 seconds. However, frontal lobe seizures tend to occur in clusters, especially when the seizures are not controlled by medication. A cluster is when three or more seizures happen within 24 hours. As stated earlier, frontal lobe seizures often occur at night.

The symptoms of a frontal lobe seizure can be quite diverse. Some symptoms are listed below:

  • Loss of consciousness or awareness
  • Temporary confusion
  • Staring blankly into space
  • Uncontrollable jerking of the arms or legs
  • Repetitive body movements (i.e., rocking, bicycling, or pelvic thrusting)
  • Abnormal body posturing
  • Sleepwalking
  • Urinary incontinence
  • Head deviation to one side of the body
  • Eye movement to one side of the body
  • Difficulty speaking
  • Explosive screaming, swearing, or laughter

One should immediately seek help in any of the following situations:

  • The seizure is more than five minutes long
  • The seizure is immediately followed by a second seizure
  • One does not recover or regain consciousness afterwards
  • One is pregnant at the time of the seizure

Causes

A frontal lobe seizure occurs when neurons emit uncontrolled bursts of electrical signals within the frontal lobe of the brain. But what causes this abnormal electrical activity? For a comprehensive list of causes, reference the following medical conditions:

It is important to note that there is one rare, genetic condition that causes frontal lobe seizures. It is called autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). It is a rare disorder that can be inherited from one’s parents.

Reference Articles

Risk Factors

Three risk factors for the development of frontal lobe seizures are:

  • Family history

Being related to someone who has frontal lobe seizures increases one’s odds of having them as well.

  • History of infections – Certain infections have lasting effects on the brain. Examples include encephalitis, meningitis, cysticercosis, and HIV.
  • Brain damage – The size and location of the frontal lobes makes them susceptible to injury due to head trauma. However, head trauma is not the only way to cause brain damage. Oxygen deprivation, stroke, degenerative brain disease, drug use, and alcohol abuse all lead to varying degrees of brain damage. Having brain damage due to any of these conditions increases one’s chances for developing frontal lobe seizures.

Diagnosis

A neurologist is a doctor who diagnoses and treats seizures. To reach a diagnosis, the neurologist will first ask the patient to describe their seizure in as much detail as possible. This includes any details of what preceded the seizure (i.e., an aura) and what transpired afterwards. If possible, the neurologist will consult with anyone who witnessed the seizure. Video recordings are also beneficial for diagnosis.

A neurologist also relies on various brain imaging techniques to diagnose frontal lobe seizures. Brain imaging techniques allow the neurologist to:

  • Look for structural abnormalities within the brain that may be causing the seizures
  • Isolate the focal point for the seizures

Brain imaging techniques include the following: CT scan, MRI, fMRI, PET scan, SPECT test, SISCOM, and MEG.

Complications

If left untreated, frontal lobe seizures can lead to the following complications:

  • Injuries incurred during a seizure (i.e., from falling or being in a car accident)
  • Mood problems (i.e., depression and anxiety)
  • Attention-deficit / hyperactivity disorder (ADHD)
  • Social isolation
  • Status epilepticus
  • Sudden unexplained death in epilepsy (SUDEP)

Treatment

Many of those who suffer from frontal lobe seizures are able to control their seizures with antiepileptic drugs (AEDs). However, for some individuals, medication is not sufficient in controlling their seizures. In these cases, other treatment options may be considered. They include the following:

  • Surgery
  • Vagus nerve stimulation (VNS)
  • Deep brain stimulation (DBS)
  • Responsive neurostimulation (RNS)
  • Ketogenic diet

If you are having signs or symptoms of a seizure or your current treatment plan is not effective in preventing frontal lobe seizures, contact your doctor right away.

 
 
 

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