F rontal lobe epilepsy fle is the second most common type of epilepsy characterized by periodic seizures that arise in the frontal lobes of the brain. The frontal lobe and epilepsy relatively unexplored. The left side of the brain controls movement related to language, whereas the right side is responsible for nonverbal tasks. Memory deficits are traditionally attributed to temporal lobe epilepsy, whereas the impact of frontal lobe epilepsy on memory functions has remained controversial. Summary objective frontal lobe seizures are difficult to characterize. Nocturnal frontal lobe epilepsy was first described in 1981 in 5 people with peculiar movements that happen in sleep. Frontal lobe epilepsy fle is a neurological disorder that is characterized by brief, recurring seizures that arise in the frontal lobes of the brain, often while the patient is sleeping. It is the second most common type of epilepsy, following temporal lobe epilepsy. Frontal lobe seizures diagnosis and treatment mayo clinic. Recent studies have reported moderate to severe memory disturbances.
Major technological advances in the ability to delineate structural and functional brain regions have led to a resurgence of interest in epilepsy surgery. The frontal lobe, a large area of the brain, controls decision making, physical movements and selfcontrol. Mesial temporal lobe epilepsy mtle involves the medial or internal structures. As they mentioned, carbamazepine is gener this has been interpreted in terms of a carbamazepinemediated ally considered the firstchoice treatment in nocturnal frontal lobe inhibitory effect on the hyperfunctional, mutated neuronal ace epilepsy, with a proposed mechanism of action through the inhibi tylcholine. Nocturnal frontal lobe epilepsy nfle is a condition primarily characterized by seizures occurring exclusively or predominantly during sleep, the semiology of which suggest a frontal lobe origin and, more specifically, the involvement of the orbitofrontal or mesial frontal regions. The typical seizure semiology for fle includes unilateral clonic, tonic asymmetric or hypermotor seizures. The central lobe is sometimes described as the region formed by the primary motor cortex and the sensory cortex brodmann areas 4 and 3 fig. Distinctive polysomnographic traits in nocturnal frontal lobe. There are 5 parallel, separate circuits alexander et al, 1986. Nocturnal frontal lobe epilepsy brain oxford academic. About onequarter of patients with refractory focal epilepsies have frontal lobe epilepsy fle. This disease affects men and women and does not seem to be more prevalent in any particular race. What is the prognosis of a patient with a frontal lobe tumor. Figure 3 from frontal lobe epilepsy semantic scholar.
Pdf neuropsychological performance in frontal lobe epilepsy. The frontal lobe cortex forms a part of the frontal subcortical circuits these have been described in detail in chapter 2. This disorder causes seizures that usually occur at night nocturnally while an affected person is sleeping. In brief, each circuit has a direct and an indirect route. Frontal lobe seizures symptoms and causes mayo clinic. If there are changes in surgeries or other scheduled appointments, your provider will notify you. The first was published in 1997,2 followed by guidelines focused on patients with drug. Frontal lobe epilepsy fle probably represents 2030% of partial seizures. Learn about cortical strokes that involve the cerebral cortex and may involve the frontal lobe, temporal lobe, parietal lobe, or occipital lobe. Neuroimaging modalities have broadened the scope of what are now considered surgically. It is usually considered as a relatively benign and homogeneous epileptic syndrome, the neuropsychological impact of which should be minimal. Surgical therapy for frontal lobe epilepsy syndromes can be dated to discoveries of cortical localization towards the end of the nineteenth century. League against epilepsy ilae has thus produced consensus recommendations on the use of mri in the diagnosis and management of people with epilepsy. Frontal lobe seizures are also associated with a rare inherited disorder called autosomal dominant nocturnal frontal lobe epilepsy.
Pdf sleeprelated minor motor events in nocturnal frontal. Interictal electroencephalograms eeg usually reveal interictal epileptiform discharges and rhythmical midline theta, which has localizing value. Yet, little is known about longterm seizure outcome following frontal lobectomy. With diffusion tensor imaging, we have studied cerebral white matter properties and associations with cognitive functioning in children with fle and healthy controls. The central lobe is sometimes described as the region formed by the primary motor cortex and the. The seizure semiology described in adult patients is varied and dependent on site of origin within the frontal lobe 15. Jan 01, 2017 nocturnal frontal lobe epilepsy nfle is a focal epilepsy with seizures arising mainly during sleep and characterized by complex, often bizarre, motor behavior or sustained dystonic posturing. Mechanisms influence of sleep supported by specific seizure disorders have seizures only during sleep temporal lobe seizures are most common nocturnal seizures frontal lobe seizures have higher prevalence during sleep possible thalamocortical activation. The function of the brains frontal lobe includes movement, decision making, problem solving, planning, impulse control, memory and high order functions. Examining the restingstate networks rsns may help us to understand the neural mechanism of the frontal lobe epilepsy fle.
Jan 17, 2020 frontal lobe epilepsy is a form of neurological disorder characterized by brief recurring episodes of seizures that originate from the frontal part of the brain. The prognosis for a frontal lobe tumor depends on the specific tumor type, its diagnosed grade, and additional biological factors, according to the america the prognosis for a frontal lobe tumor depends on the specific tumor type, its diagn. Seizures in tle start or involve in one or both temporal lobes in the brain. Metrus, md, is boardcertified in neurology and neurooncology. Genetic, lesional, and cryptogenetic nfle forms have been described.
People were not sure if this was a movement disorder or an epilepsy syndrome. Some authors report differences in seizure semiology in childhood and report that frontal lobe epilepsy of childhood is different from that of adult patients 6,7. The clinical manifestations in patients with frontal lobe epilepsy are varied. As a group, epilepsies of frontal lobe origin are thought to be poorly localized using surface eeg recordings. Autosomal dominant nocturnal frontal lobe epilepsy epilepsy. Important advances have been made in recent decades, especially in correlations between the clinical and electrical expression of seizures, permitting better understanding of fle. Provini f, plazzi g, tinuper p, vandi s, lugaresi e.
Temporal lobe epilepsy tle is the most common form of focal partial epilepsy it can be hard for people with tle to become completely seizure free with seizure medicines alone, though medicines may lower the number of seizures people with drugresistant medial temporal lobe epilepsy have a higher risk for memory and mood difficulties surgery may help many people with tle become. Clinical manifestations could be categorized into six types. Claudia chaves, md, is boardcertified in cerebrovascular disease and neurology with a. We evaluated ictal 99mtechnetium hexamethyl propyleneamineoxime singlephoton emission computed tomography spect in 22 children with electroclinical features of frontal lobe epilepsy fle. Pdf neuropsychological performance in frontal lobe. Autosomal dominant nocturnal frontal lobe epilepsy. Nocturnal frontal lobe epilepsy nfle is a particular dering, to paroxysmal arousals frequent, abrupt, and brief form of partial epilepsy in which seizures appear almost arousals associated with stereotyped movements of the exclusively during sleep.
Especially in frontal lobe epilepsy seizure spread has been shown to be extremely rapid15. Sep 02, 2020 frontal lobe epilepsy is a neurological disorder that is characterized by brief, recurring, partial seizures originating from the frontal lobe. Because the frontal lobe is responsible for planning and executing movement and personality, frontal lobe epilepsy can have a. For epileptologists today, frontal lobe epilepsy fle remains. Frontal, temporal, parietal, occipital lobe strokes. May 16, 2002 frontal lobe epilepsy has been better understood during the past two decades with the advent of technologies with improved localizing capabilities. Because the frontal lobe is responsible for planning and executing movement and personality, frontal lobe epilepsy can have a dramatic effect on a patients quality of life. But doctors arent always able to figure out why it happens. Sep 20, 20 cognitive impairment is frequent in children with frontal lobe epilepsy fle. We studied the incidence, positive predictive value ppv, and the lateralizing significance of various clinical symptoms in 228 seizures s of 31 patients p with medically refractory fle 17 with leftsided and 14 with rightsided seizure onset. Pdf oxcarbazepine in nocturnal frontallobe epilepsy.
Clinical seizure lateralization in frontal lobe epilepsy. From nocturnal frontal lobe epilepsy to sleeprelated. The aetiology of frontal lobe epilepsy is varied, clinical semiology is diverse and seizures are often frequent, disabling and refractory to treatment. About 150,000 people are diagnosed with it each year in the u. Oct 01, 2010 these findings suggest that memory dysfunction in frontal lobe epilepsy may vary depending on the localization of the seizure focus andor the spread of seizure activity. Pathways linking the frontal lobes with the temporal lobes have been described16 and may be the route by which seizure activity in frontal. Abstract nocturnal frontal lobe epilepsy nfle is a syndrome of heterogeneous etiology, characterized by the occurrence of sleeprelated seizures with different complexity and duration. Stephan eisenschenk, md department of neurology 12 sleep and epilepsy.
Surgical outcome and prognostic factors of frontal lobe. The independent component analysis ica method was used to identify rsns from each group. Prognostic factors in presurgical assessment of frontal. Prognostic factors in presurgical assessment of frontal lobe. Clinical seizure semiology can provide valuable lateralizing and localizing information during presurgical evaluation in patients with medically refractory epilepsy. Frontal lobe epilepsy seizure european journal of epilepsy. It is the second most common type of epilepsy after the temporal lobe epilepsy. We systematically analyzed the lateralizing value of clinical seizure semiology in patients with frontal lobe epilepsy fle. Autosomal dominant nocturnal frontal lobe epilepsy adnfle is an uncommon form of epilepsy that runs in families.
First described in 1981, it was initially considered a motor disorder of sleep and was named nocturnal paroxysmal dystonia npd. Preoperative electroencephalographic investigation in. Yet, little is known about longterm seizure outcome following frontal. The main genetic cause of frontal lobe epilepsy is an autosomal dominant disease called autosomal dominant nocturnal frontal lobe epilepsy, which involves mutations in 2 nicotinic acetylcholine receptor genes. It represents the second most common procedure performed to treat pharmacoresistant epilepsy after temporal lobectomy janszky et al. Our understanding of the temporal lobes, the nature. Collectively, the frontal lobe the left side of the brain controls movement related to language, whereas the right. Temporal lobe epilepsy is the most common form of focal epilepsy. Restingstate functional mri fmri data were acquired from 46 patients with fle study group and 46 age and gendermatched healthy subjects control group. It is the second most common type of epilepsy after temporal lobe epilepsy tle, and is related to the temporal form by the fact that both forms are characterized by the occurrence of partial focal seizures. Epilepsy is one of the most common brain disorders. The eeg shows sharp waves involving right central and midline central regions. Diana apetauerova, md, is boardcertified in neurology with a subspecialty in movement disorder. This finding may depend on the specific areas of frontal lobe from which the seizures originate or the pathologic substrate.
Specific cognitive deficits have been identified in children with epilepsy irrespective of results on intelligence tests. John hughlings jackson reflected that the frontal lobe is the brains most. Frontal lobe epilepsy fle surgery is the second most common surgery performed to treat pharmacoresistant epilepsy. Frontal lobe epilepsy clinical seizure semiologyclinical seizure lateralization. Nocturnal frontal lobe epilepsy nfle occurs sporadically or as an inherited form with an established genetic basis autosomal dominant nfle adnfle. Frontal lobe epilepsy is the term for recurring seizures beginning in the frontal lobe the area of the brain behind the forehead. T the function of the brains frontal lobe includes movement, decision making, problem. Insular cortex epilepsy is an underrecognized, localizationrelated syndrome. While most neuropsychological studies in focal epilepsies are concerned with temporal lobe epilepsy tle, only few investigations aim cognitive functioning in unresected patients with. Nfle is generally considered a benign clinical entity, although severe, drugresistant forms do exist. Nocturnal frontal lobe epilepsy nfle is a syndrome of heterogeneous etiology, characterized by the occurrence of sleeprelated seizures with different complexity and duration. The aim of this study was the examination of memory abilities in other childhood common epilepsy syndromes. Pdf nocturnal frontal lobe epilepsy nfle is a syndrome of heterogeneous etiology, characterized by the occurrence of sleeprelated.
Dorsolateral frontal lobe epilepsy dorsolateral fle may be further subdivided into central, premotor and prefrontal lobe epilepsy. The presence of this condition could account for the surgery treatment failure seen in a portion of patients with temporal epilepsy, as well as a portion of those with frontal and parietal lobe epilepsy. Reported success rates range from to 80% rasmussen, 1991. Neuropsychological performance in frontal lobe epilepsy. A frontal lobe stroke can cause a number of neurological deficits because the frontal lobe, a large part of the brain, has important functions. Neuropsychological aspects of frontal lobe epilepsy. A few studies have reported memory disturbance in genetically characterized frontal lobe epilepsy syndromes. A genetic mutation on chromosome 22 has also been associated with another genetic form of the disorder.
Interictal electroencephalogram eeg in longitudinal bipolar montage of a 16yearold female with a right frontal epilepsy due to right inferior frontal gyrus cortical dysplasia. Ictal spect demonstrated unilateral frontal hyperperfusion in 20 of 22 children 91% one lobar, two frontocentral, six dorsolateral, six frontopolar, three orbitofrontal, one medial frontal, and one. Some people with adnfle also have seizures during the day. We continue to provide inperson care and telemedicine appointments. Violent movements of arms or legs and strange posturing were seen, similar to seizures seen in people having eeg electroencephalogram monitoring. About 6 out of 10 people with focal epilepsy have temporal lobe epilepsy. Electrical basis of epilepsy as the concept of a brain disorder gradually took hold between the 17th and 19th centuries it was widely believed that epilepsy.
While some people require treatment throughout the. If one of your parents has this form of epilepsy, you have a 50 percent chance of inheriting the abnormal gene that causes this disorder and developing the disease yourself. Altered intrinsic connectivity networks in frontal lobe. Frontal lobe seizures can be divided into perirolandic, supplementary sensorimotor area, dorsolateral, orbitofrontal. Neurocognitive and behavioral functioning in frontal lobe. Epilepsy affects the central nervous systems and allows abnormal activity within the brain. Frontal lobe epilepsy accounts for only 1020% of the patients in surgical series, but the incidence in nonsurgical patient cohorts seems to be much higher. Frontal lobe epilepsy fle surgery accounts for 630% of all epilepsy surgeries. Seizure type frontal lobe seizures more commonly begin during sleep, while temporal lobe seizures begin more commonly awake. This is very evident in comparison to the now welldefined syndrome of mesial temporal lobe epilepsy tle.
It is usually considered as a relatively benign and homogeneous epileptic syndrome, the neuropsychological impact of which. Differentiating frontal lobe epilepsy from psychogenic. We assessed all seizures from 54 patients with frontal lobe epilepsy that were. Explore symptoms, inheritance, genetics of this condition. Autosomal dominant nocturnal frontal lobe epilepsy adnfle is an.
Introduction john hughlings jackson reflected that the frontal lobe is the brains most complex and least organized centre jackson 1931 and, despite subsequent advances in neuroscience, even by the late 20th century the frontal lobe was still considered to be an uncharted province of the brain goldmanrakic 1984. Mesial frontal epilepsy the mesial surface of the frontal lobe includes primary sensory and motor cortex for the lower limb, the supplementary sensorimotor area ssma, the anterior cingulate cortex and the prefrontal cortex31 fig. The typical seizure semiology for fle includes unilateral clonic. On the basal orbital surface of the frontal lobes, five gyri can be identified.
371 207 1481 809 484 351 1245 939 561 1335 1282 635 1149 805 295 1156 1305 1216 1143 1653 838 102 1484 1604 1343 898 411 148 1263