Frontal Lobe Seizures – Diagnosis and Treatment
Diagnosis
Identifying frontal lobe seizures can be challenging because the symptoms can look like mental health conditions or sleep issues, such as night terrors. Sometimes, symptoms overlap with seizures that start in other brain areas, making a clear diagnosis more complex.
A medical professional begins the process by looking at the patient’s symptoms and medical background. This step often includes a physical exam and blood tests to check for any underlying conditions that might trigger seizures.
A neurological exam is often part of the process. This assessment checks:
- Muscle strength
- Sensory abilities
- Speech and hearing
- Vision
- Coordination and balance
Several important tests help provide more evidence:
| Test Type | Purpose | What is Involved |
|---|---|---|
| Magnetic Resonance Imaging (MRI) | Shows detailed images of the brain’s soft tissue | Patient lies in a scanner; painless; may take about an hour |
| Electroencephalogram (EEG) | Measures electrical activity in the brain | Small electrodes placed on the scalp to record brain waves |
| Video EEG Monitoring | Matches seizure events on video with changes in brain activity | Overnight monitoring with both video and EEG, often done in a clinic |
MRI scans help locate brain abnormalities, like tumors or injuries, that might be causing the seizures. The strong magnetic fields and radio waves give clear images of possible issues in the frontal lobes.
An EEG tracks brain wave patterns and helps detect epileptiform activity. However, regular EEGs do not always show clear signs of frontal lobe epilepsy.
In those cases, a video EEG provides both video and brainwave monitoring, so doctors can connect physical symptoms with electrical changes in the brain during a seizure.
Treatment
Medicines for Frontal Lobe Seizures
Different antiepileptic medicines help manage seizures that start in the frontal lobe. All major antiepileptic drugs appear to have similar success for this type of seizure.
People might need to try several medicines or use them in combinations to find what works best. Some may not achieve complete seizure control with medication alone.
List of common medications:
| Medicine Name | Typical Usage | Notes |
|---|---|---|
| Sodium channel blocker (anticonvulsant) | Oral, daily | Monitored for side effects |
| Hydantoin-class anticonvulsant | Oral or injectable | Blood levels monitored |
| Broad-spectrum antiepileptic agent | Oral, daily | Not always for women of childbearing age |
| Newer antiepileptic options | Varies | May offer fewer side effects |
Doctors adjust doses or switch medicines based on how well seizures are controlled and if there are any side effects. Research efforts continue to develop medications that are even more effective and safer.
Surgical and Device-Based Options
When medicines do not control seizures, doctors may recommend surgery or implanted devices.
Before recommending surgery, doctors use techniques like SPECT scans or functional MRI (fMRI) to find where the seizures are starting in the brain. Brain mapping is another tool.
It uses electrodes to check the functions of different brain areas and prevent removing important parts of the brain.
Types of procedures and devices:
- Removing the seizure focus. If seizures start in a single small spot, surgeons can sometimes remove that part, which may greatly lower the number of seizures or stop them.
- Isolating the source. When a seizure focus is in a critical area, surgeons may cut pathways around it to keep it from spreading.
- Vagus nerve stimulation. Surgeons can implant a small device under the skin to send signals to the vagus nerve, helping to control seizures for many people.
- Responsive neurostimulation. This newer device detects the start of a seizure and gives targeted electrical pulses to stop it before it develops.
- Deep brain stimulation (DBS). Surgeons place electrodes deep in the brain, connected to a device that sends signals to block seizures.
Everyday Habits and At-Home Practices
Paying attention to regular sleep, tracking seizures in a diary, and wearing medical alert identification can help manage seizures. Some people benefit from a ketogenic diet.
Reducing alcohol, quitting smoking, and lowering stress levels are also important. Keeping a consistent routine and avoiding common triggers supports better seizure control.
Managing Emotional Well-being and Getting Help
Living with frontal lobe seizures can cause stress and anxiety, especially when symptoms happen in public or seem embarrassing.
Children and their parents might find relief by joining support groups, which offer resources and a place to share feelings.
Adults can take part in online or local support networks. Counseling can help both children and adults manage emotional challenges linked to epilepsy.
Getting Ready for Your Visit
Steps You Can Take Before the Appointment
- Bring Support: Ask a family member or friend to come to the appointment. They can assist in recalling details or information that may be discussed.
-
Prepare an Information List:
Create a list including:- Symptoms: Write down every symptom, no matter how small or unrelated it seems. Include details about movement changes, repetitive movements, speech or vision problems, impaired awareness, motor symptoms, any muscle spasms, and when they started or how often they occur.
- Current Medications: Note all medicines, vitamins, and supplements, including the dose for each one.
- Medical History: Mention any personal or family history of epilepsy, injury, stroke, infection, brain tumor, meningitis, or other relevant conditions.
- Questions for the Health Provider: Use a table like the one below to keep organized.
| Sample Questions for the Health Provider |
|---|
| What may be causing my symptoms? |
| Will I likely have more or different types of seizures? |
| What testing should I expect, such as video EEG monitoring, PET scan, SPECT scan, or neuroimaging such as computed tomography? |
| Could this be related to problems like Broca’s area aphasia, cingulate cortex issues, or Dravet syndrome? |
| What treatment options are available? |
| Will there be activity restrictions, such as driving? |
| Are there resources for learning about safety (like avoiding injury, SUDEP, or sudden unexpected death in epilepsy)? |
What the Healthcare Provider Is Likely To Ask
- The provider may want to know about any changes before, during, or after seizures, such as loss of consciousness, aphasia, dysphasia, gelastic seizures (sudden laughing), or a sequence of symptoms (like the jacksonian march).
- Be ready to discuss:
- How often seizures happen and their length
- Whether seizures happen in groups, or if there are different types
- Observations about awareness and possible triggers (such as illness, sleep problems, or medication changes)
- If anyone in the family has had similar symptoms or seizures
- The healthcare provider might also ask about personal or family history of conditions that could increase risk, such as prior stroke, brain tumor, infection, injury, or parasomnias.
- The healthcare provider may ask about any past scans, test results, or recent increases in seizure frequency or severity.
