A frontal lobe seizure is a form of partial (focal) epilepsy. The seizures start in the front part of your brain, behind your forehead. They often happen at night, causing sleep disturbances or behavior changes. Treatments include medication, diet modifications, electrical stimulation or surgery.
A frontal lobe seizure results from a period of abnormal electrical activity in the front section of your brain, behind your forehead. The frontal lobes are the largest of the four lobes in the brain. They’re responsible for:
Frontal lobe seizures are a type of partial (focal) epilepsy. This means that the seizures start in one area of the brain instead of multiple areas. In addition to seizures, frontal lobe epilepsy can cause personality changes or sleep disturbances. It’s often misdiagnosed as a mental health disorder or sleep disorder.
Frontal lobe seizures can affect people while they’re awake or asleep, but are more common at night. Nocturnal frontal lobe epilepsy (NFLE) occurs when people only experience the seizures in their sleep.
Frontal lobe seizures can occur in people of any age or gender. The risk factors are similar to those of epilepsy and include:
Frontal lobe epilepsy makes up approximately 20 to 30% of all focal epilepsies.
About half of frontal lobe seizures are the result of brain development problems. Sometimes the cortex, or outermost layer of the brain, doesn’t form properly during fetal development.
Other causes include:
One particular form of nocturnal frontal lobe epilepsy is due to a change in one or more genes. It’s inherited, meaning parents can pass it on to their children. This form, autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), is very rare.
Frontal lobe seizures usually last a short time (less than 20 seconds), but they can happen in clusters. You may or may not lose consciousness or have problems with awareness.
Some people have an “aura”, or warning feelings, at the start of a frontal lobe seizure. An aura might make you feel dizzy or unbalanced, as if you’re falling. It can also cause tingling, numbness, hallucinations or a sense of fear or panic.
Frontal lobe seizures usually happen during sleep and can lead to:
After a frontal lobe seizure, you have memory loss or feel confused and groggy.
Complications of frontal lobe seizures can include:
Your healthcare provider reviews your medical history and performs a physical exam. They may also do neurological testing. The following tests can help diagnose frontal lobe seizures:
Your healthcare provider may treat frontal lobe seizures with:
Anti-seizure medication, such as oxcarbazepine or other drugs, is usually the first treatment for frontal lobe seizures. It regulates electrical activity in your brain, stopping seizures or reducing their frequency. But for about 30% of people, the medications are not fully effective. In these cases, healthcare providers consider the possibilities for other treatments such as surgery.
Your healthcare provider may recommend a special diet if your seizures don’t improve with medication. The ketogenic diet for epilepsy is a high-fat, low-carbohydrate diet that changes how your cells use energy. About 50% of people who adjust their diet have fewer seizures; 10% are free from seizures. It tends to be more effective for children with epilepsy. Adults have a harder time sticking to the strict diet.
People who have frontal lobe seizures that don’t respond to medication may consider epilepsy surgery. During a frontal lobe resection, a surgeon removes the part of your frontal lobe that is causing seizures.
Before surgery, the surgeon makes detailed maps of your brain using imaging scans. They may also surgically implant electrodes to do a specialized EEG from recording inside your brain. All of this information helps your neurologist and surgeon to:
Neuromodulation is a therapy using electrical stimulation to change the way brain cells work. Your healthcare provider may recommend neuromodulation for your seizures if medications don’t work and surgery is not an option. Common types of neuromodulation include:
There’s no way to prevent frontal lobe epilepsy, but you may be able to prevent or limit the number of seizures you have by:
Some people need medication to manage seizures for the rest of their lives. For others, seizures may stop over time and medication isn’t needed anymore. Never stop your medication or change the amount you take without talking to your healthcare provider.
If you have frontal lobe epilepsy:
Contact a healthcare provider right away if you experience thoughts of suicide. You can call the Suicide and Crisis Lifeline at 988. This hotline connects you to a national network of local crisis centers for free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.
A note from Cleveland Clinic
Frontal lobe seizures are a form of epilepsy. They start in the front part of your brain and usually occur during sleep. These seizures can affect children or adults. Anti-seizure medication is usually the first line of treatment for frontal lobe epilepsy. Other treatments include surgery, special diets or devices that regulate your brain activity.
Last reviewed by a Cleveland Clinic medical professional on 07/21/2021.
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