By: Aliana Gordon
Frontal Lobe Epilepsy
What is Frontal Lobe Epilepsy?
Frontal lobe epilepsy affects the area of the brain responsible for speech, motor skills, personality, and forming memories. It is the second-most common type of epilepsy that causes clusters of brain cells to send abnormal signals resulting in seizures. A genetic component could cause frontal lobe epilepsy (FLE) with a 50% inheritability rate for the abnormal gene. Other abnormalities such as a stroke, injury, tumors, or infections can cause FLE, but the cause is unknown approximately half of the time. The frontal lobe is large, resulting in an array of unusual symptoms that can appear to be related to psychiatric problems or a sleep disorder when experiencing frontal lobe seizures. Depending on the area of the frontal lobe involved, seizures with distinctive features become prominent such as the autosomal dominant nocturnal frontal lobe epilepsy, a genetic condition where the seizures occur at night.
What does the Frontal Lobe do?
The frontal lobe is responsible for cognitive skills such as emotional expression, problem solving, memory, language, and judgment. Cognitive functions such as maintaining attention, high-level thinking, and problem-solving also occur in the frontal lobe.
The frontal lobe allows humans to:
- Recognize the feelings of others
- Categorize and classify objects
- Put thoughts into words
- Release dopamine for feelings of reward and motivation
- Regulate emotions
- Have self-control
- Make decisions
The frontal lobe also houses the primary motor cortex, which is responsible for coordinating voluntary movement like walking. One of the frontal lobe’s unique aspects is that the right frontal lobe controls the left side of the body and the left frontal lobe controls the right. Language, logical thinking, and analytical reasoning take place in the left and right frontal lobes. With the frontal lobe’s significant responsibilities, some brain disorders may appear such as attention deficit hyperactivity disorder (ADHD). Additionally, habits and behaviors contribute to forming one’s personality.
Frontal lobe seizures are usually short, lasting around 30 seconds with quick recovery times. The seizures might begin with a slight aura, which is an unusual feeling, experience, or movement. With FLE being one of the most common forms of epilepsy, it is usually indicated by partial seizures, which is abnormal electrical discharge restricted to one small region of the brain. The seizures may be exclusively nocturnal and appear in clusters, which are closely grouped series of seizures. Although the seizures are brief, various effects can be seen to impact vocalizations and motor functions. The motor functions are prominent and can result in a range of differentiating seizures, such as focal hyperkinetic seizures with pelvic thrusting & bipedal kicking or pedaling to focal bilateral motor seizures with asymmetric tonic posturing. Signs and symptoms of frontal lobe seizures may include:
- Prominent vocalization (i.e., explosive screams)
- Unusual behavior
- Urinary incontinence
- Head and eye movement deviation
- Abnormal body posture
- Repetitive movements
- Complete or partial unresponsiveness or difficult speaking
A diagnosis is needed from one of the following methods: electroencephalogram (EEG), computed tomography (CT or CAT) scan, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan. Following a diagnosis, doctors would map the brain and pinpoint the correct area where the abnormal activity is taking place to determine the best course of action. Medication is a standard treatment to reduce the number of seizures but does not always lead to being seizure-free. Vagus nerve stimulator (VNS) can be surgically placed under the skin to stimulate the vagus nerve to aid in seizure control. Other options such as responsive neurostimulation (RNS) is another form of therapy that monitors the brain waves and any occurring abnormal activity. The RNS provides pulses of stimulation to help brainwaves return to normal. Surgery is one of the last options physicians will resort to due to it being very invasive. If the origin of the seizures does not perform vital functions, surgeons may remove the portion of the brain. If the origin performs vital functions, a series of cuts could be made to try to isolate the area from causing seizures to go to other parts of the brain. If surgeons cannot remove the affected area, a magnetic resonance imaging (MRI) guided laser can be done in place of surgery as a minimally invasive option.
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“Symptoms and Causes of Frontal Lobe Brain Damage.” Verywell Health, 2020, www.verywellhealth.com/the-brains-frontal-lobe-3146196.
“What Does the Frontal Lobe Do?” Medicalnewstoday.com, Medical News Today, 29 June 2017, www.medicalnewstoday.com/articles/318139.
“FRONTAL LOBE SEIZURE.” Epilepsydiagnosis.org, 2020, www.epilepsydiagnosis.org/seizure/frontal-lobe-overview.html.
University of Wisconsin Hospitals and Clinics Authority. “Frontal Lobe Epilepsy (FLE).” UW Health, 2020, www.uwhealth.org/epilepsy-seizures/frontal-lobe-epilepsy-fle/40340.