Frontal Lobe Seizure: Let's understand this simply

Have you ever seen someone in your family, perhaps your child, suddenly wake up at night, screaming, flailing their arms and legs, acting strangely? Or do you suddenly show strange behavior, such as cursing or laughing, even during the day? Many people think that this is a bad dream or a mental problem, but this could be a seizure that occurs in the brain. Today we are talking about a special type of seizure, which is called 'Frontal Lobe Seizure'. Don't be scared when you hear this name, let's talk about everything simply.

What is Frontal Lobe Epilepsy?

Simply put, this is a type of epilepsy. The front part of our brain, the part behind the forehead, is called the ``Frontal Lobe''. This is the largest part of our brain. This part controls many important things, such as our behavior, personality, thinking, decision-making, learning, speaking, and body movement.

So, a `Frontal Lobe Seizure`, or seizure, occurs when the electrical activity of the neurons in the `Frontal Lobe` suddenly becomes abnormal and uncontrolled. Because it starts in one specific part of the brain, we also call it ``focal seizure``.

Because these seizures often occur at night during sleep, some people mistakenly think that this is a sleep disorder or a mental illness. However, it is very important to diagnose and treat this correctly.

What are the symptoms of this seizure?

These seizures are not the same for everyone. But there are some common symptoms. They are usually very short-lived, sometimes lasting less than a minute. And they can occur several times within 24 hours.

Imagine, while your child is sleeping at night, suddenly sitting up in bed and starting to kick his legs as if he were riding a bicycle, or flailing his arms wildly, screaming. Anyone would be scared if they saw something like this, wouldn't they? The table below shows the signs that can be seen at such times.

Things you feel before a seizure (Aura)

Some people experience a strange feeling just before a seizure. We call this an ``aura''. Not everyone gets this either. But people who do may experience things like:

• Sudden feelings of fear, anger, and sadness.
• Feeling like your body is tingling.
• Changes in smell, hearing, and sight.

After the seizure is over, in the ``postictal state'', a person may feel disoriented, have memory loss, and experience body aches for a while.

Why does this kind of seizure occur?

It's not always possible to pinpoint the exact cause, but there are a few common factors that can contribute to this condition.

• Problems at birth: Any abnormalities that occur during the development of the baby's brain in the womb.
• Brain infections: Infectious conditions that affect the brain during childhood.
• Head injuries: A serious head injury (Traumatic brain injury).
• Stroke: Brain damage caused by interruption of blood flow to the brain.
• Brain tumor: Any growth that occurs in the brain.
• Genetic causes: Sometimes this condition can be inherited, but this is very rare.

Risk factors that contribute to this condition

Although this condition can occur at any age, some people are at higher risk.

• If someone in the family has epilepsy.
• If you had a brain infection as a child.
• If you have a stroke, head injury, or brain tumor.
• If you were born with some brain abnormalities at birth.

Is this situation dangerous? What are the risks?

Although having a seizure may seem scary at first glance, it can be well controlled with proper treatment. However, if seizures occur frequently and are not treated, there may be some risks.

• Physical injury: You may be injured by falling or being thrown out of consciousness during a seizure.
• Status Epilepticus: This is an emergency condition. This occurs when a seizure lasts for more than 5 minutes or when one seizure ends and another one begins before consciousness returns. In such cases, the patient should be taken to a hospital's Emergency Treatment Unit (ETU) immediately.
• SUDEP (Sudden Unexplained Death in Epilepsy): This is a very rare condition. A person with epilepsy dies suddenly and for no apparent reason. With proper treatment, this risk can be greatly reduced.

It's normal to feel some mental stress when living with a condition like this. So, you can talk to your doctor and seek the help of a mental health professional if necessary.

How does a doctor find this?

When you tell your doctor about these symptoms, he will ask you a detailed question and examine you. He will then order several tests to confirm the diagnosis.

• MRI Scan: An MRI scan can take detailed pictures of your brain. It can check for any abnormalities, such as a brain tumor or a brain lesion.
• EEG (Electroencephalography): This measures the electrical activity in your brain, or rather the 'current' in your brain. This can help determine where in the brain the seizure is starting.
• Video EEG: This involves videotaping you while you are connected to an EEG. This usually requires a day in the hospital. This helps to compare both your behavior and brain activity during a seizure.
• SEEG (Stereoelectroencephalography): This is only done if medication fails to control seizures and surgery is being considered. This involves surgically inserting electrodes into the brain to monitor electrical activity deep within the brain.

What are the treatments for this?

The main goal of treatment is to reduce the frequency of seizures, and if possible, stop them completely.

1. Antiseizure medications

This is the first treatment. These medications control the abnormal electrical activity in the brain. Your doctor will choose the right medication for you based on your symptoms. Sometimes it can take a while to find the right medication and the right dosage.

2. Surgery (Epilepsy surgery)

If medication alone is not enough to control the seizures, your doctor may consider surgery. This involves removing a small part of the brain that is causing the seizures. The brain is carefully mapped before surgery, so that important functions are not affected.

3. Neuromodulation

This method can be used when surgery is not possible. It involves implanting a small device inside the body that sends electrical signals to the brain to stop seizures.

• Vagus Nerve Stimulation (VNS): A small device is implanted under the skin of the chest, which stimulates the vagus nerve in the neck.
• Responsive Neurostimulation (RNS): A device is implanted in the skull. This monitors brain activity and sends electrical signals only when it senses that a seizure is about to occur.
• Deep Brain Stimulation (DBS): This is similar to `VNS`, but in this case, electrical signals are sent directly to the deeper parts of the brain.

Your doctor will discuss with you which of these treatments is best for you.

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