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Treatments and drugs
By Mayo Clinic staff
Over the past decade, treatment options have increased for frontal lobe seizures. There are newer types of anti-seizure medications and a variety of surgical procedures that may help if medications don't work.
Medications
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.
Surgery
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 — brain 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.
Surgery for epilepsy may involve:
- 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. The device is inserted under the skin of your chest, and wires from it are threaded under your skin and then wrapped around the vagus nerve in your neck. This procedure usually reduces the number of seizures people experience.
- Frontal lobe epilepsy. Epilepsy Foundation. http://www.epilepsyfoundation.org/about/types/syndromes/frontallobe.cfm. Accessed July 29, 2010.
- Seizures and epilepsy: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm. Accessed July 29, 2010.
- Benbadis SR. Localization-related (partial) epilepsy: Causes and clinical features. http://www.uptodate.com/home/index.html. Accessed July 29, 2010.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed July 29, 2010.
- Patrikelis P, et al. Neurocognitive and behavioral functioning in frontal lobe epilepsy: A review. Epilepsy & Behavior. 2009;14:19.
- Aminoff MJ, et al. Nervous system disorders. In: McPhee SJ, et al. Current Medical Diagnosis & Treatment. New York, N.Y. McGraw-Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=12507. Accessed July 29, 2010.
- Schachter SC. Surgical therapy of epilepsy in adults. http://www.uptodate.com/home/index.html. Accessed July 29, 2010.
- Schachter SC, et al. Vagus nerve stimulation therapy. http://www.uptodate.com/home/index.html. Accessed July 29, 2010.
- Sirven JI (expert opinion). Mayo Clinic, Scottsdale, Ariz. Aug. 5, 2010.
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