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Frontal Lobe Seizures: Symptoms, Types, and Treatment

Frontal lobe seizure illustration

Frontal lobe seizures are a unique form of seizures. They display distinctive features, depending on which area of the frontal lobe they occur.

Today’s article will discuss everything you need to know about frontal lobe seizures, from causes and subtypes to treatment.

Causes and Features of Frontal Lobe Seizures

Most frontal lobe seizures are caused by abnormal brain tissues that are a result of a stroke or traumatic injury.

Possibly the most unique characteristic of a frontal lobe seizure is that it tends to occur when the person is asleep. This makes it hard to diagnose them properly.

Another strange quality of these seizures is that sometimes, the person does not lose consciousness during an episode. Instead, they remain fully aware while their arms and legs move wildly about.

Also, since many areas of the frontal lobe have no known function, when a seizure begins, there may be no initial symptoms. Only if it spreads to the motor areas will it cause a classic tonic-clonic seizure.

Sometimes the seizure will only cause hallucinations, which can make people believe the person is suffering from a psychiatric disorder, when in fact they are not.

All of these features make frontal lobe seizures one of the toughest forms of epilepsy to identify and treat.

Types and Symptoms of Frontal Lobe Seizures

Red brain scan with brain waves, illustrating a frontal lobe seizure

Depending on where the frontal lobe seizure occurs, the symptoms a person displays can look radically different each time. That’s because frontal lobe seizures are only partial (or focal) seizures. They don’t affect the entire brain.

Most neurologists classify frontal lobe seizures into various subtypes. We will examine each one below.

This is not an exhaustive list, and most of the time, a person will experience multiple types at once, so diagnosis can get complicated. Nevertheless, it’s still helpful to divide frontal lobe seizures into types based on their unique features.

1. Sensorimotor Cortex Seizures

When seizures occur in the sensorimotor cortex, strange movement may result. Sometimes the person’s entire body will convulse; other times, only one side will move.

While a sensorimotor seizure is happening, the head and eyes will often turn to the side opposite to the hemisphere the seizure is happening in. For example, if the seizure occurs in the left motor cortex, the head will turn to the right.

With these types of seizures, the patient retains awareness throughout the event

2. Orbitofrontal Cortex Seizures

This next type of frontal lobe seizure does not exhibit obvious physical signs. Instead, they will cause automatisms, which are movements that look voluntary, but which the person has no control over.

Examples of automatisms include:

  • Rubbing face repeatedly
  • Rapid blinking
  • Lip smacking
  • Tapping hands and feet
  • Nodding
  • Blurting out words or sentences or other strange sounds

Some patients even start pacing when experiencing orbitofrontal seizures.

Besides automatisms, orbitofrontal seizures can impair the person’s awareness and cause them to smell scents that aren’t there.

3. Frontopolar Cortex Seizures

Frontopolar seizures are examples of the rare class of cognitive seizures. Their main distinguishing feature is forced thoughts. This refers to intrusive or disjointed thoughts that occur at seizure onset.

Most of the time, frontopolar seizures will spread and affect movement like other seizures. But sometimes their only symptom is forced thoughts, which makes diagnosis difficult.

4. Dorsolateral Frontal Cortex Seizures

Seizures that occur in this area can cause aphasia. They also tend to be accompanied by involuntary movements and forced thoughts.

With these seizures, however, the person is awake and responsive, which makes them one of the most frightening seizures to experience. Especially when they first start.

5. Cingulate Cortex Seizures

What makes these seizures so unique is that, besides causing automatisms, they also affect a person’s emotions. In rare cases, the person will start laughing uncontrollably. Neurologists call these gelastic seizures.

With this type of frontal lobe seizure, the person is in a stupor. They don’t realize what is happening.

6. Rolandic Seizures

Rolandic seizures occur near the area that separates the frontal lobe from the parietal lobe. They are characterized by odd facial movements, swallowing and chewing motions, and excess salivation.

They can also cause the person to lose control of autonomic functions such as breathing (they may start hyperventilating) and bladder control. Sometimes, that is the only thing affected.

Diagnosing and Treating Frontal Lobe Seizures

close up of doctor's hand holding a pill, a treatment for epilepsy after TBI

One way to diagnose a frontal lobe seizure is to get an EEG recording during the seizure. This is difficult for many reasons though, not least of which is that the seizures are unpredictable.

Another way involves having an MRI to determine whether there is scarring on the frontal lobe that is causing the symptoms.

The best method, however, is probably a video EEG. These are performed during an overnight sleep study. With a video EEG, a camera and an EEG run throughout the night. This allows the doctor to capture information about the seizure.

Since frontal lobe seizures frequently happen at night, this is probably the most reliable way to diagnose them.

Once your doctor knows what type of seizures you have, they will prescribe you the correct anti-seizure medication. If the medication does not help, then your doctor may need to install a vagus nerve stimulator in your neck, which is very effective at managing seizures.

Frontal Lobe Seizures: Conclusion

Frontal lobe seizures, because their symptoms are subdued compared to normal seizures, are extremely challenging to identify. Unfortunately, because their symptoms are so obscure, too many people get misdiagnosed with other disorders that share their symptoms.

But by educating yourself on what frontal lobe seizures look like, you can more quickly identify them, which will get you one step closer to finding the treatment you or your loved one needs.

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