Frontal Lobe Seizures: Electroclinical Syndromes

Authors


  • Presented in part at the 1989 American Epilepsy Society meeting in Boston, Massachusetts, 1989 and published in abstract form in Epilepsia 1989;30:0.

Address correspondence and reprint requests to Dr. V. Salanova at Department of Neurology, Indiana University Medical Center, Riley Hospital Room 5999C, 702 Barnhill Dr., Indianapolis, IN 46202-5200, U.S.A.

Abstract

Summary: To define further the electroclinical manifestations of frontal lobe epilepsy (FLE), we studied 150 seizures manifested by 24 patients; 18 patients had subdural electrode arrays (SEA). The findings in these patients clearly overlapped presumably reflecting the interconnections between functionally related frontal zones; yet the manner in which the symptoms clustered and the sequence in which they occurred generally indicated the anatomic site of the epileptogenic zone. We divided the patients into three major groups: (a) those with supplementary motor seizures, (b) those with focal motor seizures, and (c) those with complex partial seizures (CPS, psychomotor seizures). Supplementary motor seizures began with tonic posturing of the extremities. Focal motor seizures generally began with conscious contralateral version or unilateral clonic focal motor activity; tonic posturing was noted only late in the seizure. CPS (psychomotor) began with unresponsiveness at onset, followed by staring or unconscious contraversion. We compared frontal lobe seizures with temporal lobe seizures reported previously; oral-alimentary automatisms, repetitive hand movements, or looking around, were more common in temporal lobe seizures, whereas tonic posturing and bicycling movements were more common in frontal lobe psychomotor seizures.

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