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.
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.
If your seizures can't be controlled adequately with medications, your doctor may recommend surgery. 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 more accurate at identifying the area, but aren't yet widely available.
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.
In general, surgery for seizures that aren't well controlled by medication may be quite successful. Surgery for frontal lobe seizures may be less successful than for other types of seizures, but still may provide benefit.
Surgery for epilepsy may involve:
Jul. 03, 2013
- 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. Another surgical option is to implant 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.
- Seizures and epilepsy: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm. Accessed April 19, 2013.
- Frontal lobe epilepsy. Epilepsy Foundation. http://www.epilepsyfoundation.org/aboutepilepsy/syndromes/frontallobeepilepsy.cfm. Accessed April 19, 2013.
- LaFrance WC Jr, et al. Differentiating frontal lobe epilepsy from psychogenic nonepileptic seizures. Neurologic Clinics. 2011;29:149.
- Benbadis SR. Localization-related (partial) epilepsy: Causes and clinical features. http://www.uptodate.com/home. Accessed April 18, 2013.
- O'Muircheartaigh J, et al. Epilepsy and the frontal lobes. Cortex. 2012;48:144.
- Surges R, et al. Sudden unexpected death in epilepsy: Mechanisms, prevalence, and prevention. Current Opinion in Neurology. 2012;25:201.
- Leach JP, et al. Modern management of epilepsy. Clinical Medicine. 2013;13:84.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed April 19, 2013.
- Hirsch LJ, et al. Video and ambulatory EEG monitoring in the diagnosis of seizures and epilepsy. http://www.uptodate.com/home. Accessed April 18, 2013.
- Englot DJ, et al. Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: A systematic review and meta-analysis. Journal of Neurosurgery. 2012;116:1042.
- Wiebe S, et al. Epilepsy surgery utilization: Who, when, where, and why? Current Opinion in Neurology. 2012;25:187.
- Lazow SP, et al. Outcome of frontal lobe epilepsy surgery. Epilepsia. 2012;53:1746.
- Morrell MJ, et al. Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 2011;77:1295.
- Prunettia P, et al. New and forthcoming anti-epileptic drugs. Current Opinion in Neurology. 2011;24:159.
- eCommunities. Epilepsy Foundation. http://epilepsyfoundation.ning.com/. Accessed April 19, 2013.
- Living with epilepsy. Epilepsy.com. http://www.epilepsy.com/epilepsy/living_epilepsy. Accessed April 19, 2013.
- Wells RE, et al. Complementary and alternative medicine use among U.S. adults with common neurological conditions. Journal of Neurology. 2010;257:1822.
- Schachter SC. Complementary and alternative medical therapies. Current Opinion in Neurology. 2008;21:184.
- Daroff RB, et al. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-1-4377-0434-1..C2009-0-40427-6--TOP&isbn=978-1-4377-0434-1&uniqId=364938937-2. Accessed April 18, 2013.
- Nicoll D, et al. Pocket Guide to Diagnostic Tests. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aid=56995240. Accessed April 22, 2013.
- Devinsky O, et al. Alternative Therapies for Epilepsy. New York, N.Y.: Demos Medical Publishing; 2012.
- Levy RG, et al. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001903.pub2/abstract. Accessed April 26, 2013.
- Gloss D, et al. Cannabinoids for epilepsy. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009270.pub2/abstract. Accessed April 26, 2013.
- Wyllie E, et al. Wyllie's Treatment of Epilepsy. 5th ed. Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011:771.
- Scheffer IE, et al. Autosomal dominant nocturnal frontal lobe epilepsy. Brain. 1995;118:61.
- Sirven JI (expert opinion). Mayo Clinic, Scottsdale, Ariz. April 25, 2013.
- Wang A, et al. Functional magnetic resonance imaging for language mapping in temporal lobe epilepsy. Epilepsy Research and Treatment. 2012;2012:198183.
- Von Oertzen TJ, et al. Prospective use of subtraction ictal SPECT coregistered to MRI (SISCOM) in presurgical evaluation of epilepsy. Epilepsia. 2011;52:2239.
- Miller RD, et al. Miller's Anesthesia. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06959-8..X0001-5&isbn=978-0-443-06959-8&uniqId=410621892-4#4-u1.0-B978-0-443-06959-8..X0001-5--TOP. Accessed May 7, 2013.
You Are ... The Campaign for Mayo Clinic
Mayo Clinic is a not-for-profit organization. Make a difference today.