Frontal lobe epilepsies in childhood

Abstract

Frontal lobe represents complicated functional system with many interconnections, resulting in wide clinical and electrophysiological seizure spectra arising from frontal lobe. Besides autosomal dominant, nocturnal frontal lobe epilepsy which presents specific nosological entity, most of the frontal lobe seizures in childhood could be seen in broad spectrum of epilepsies with different pathogenic background and aetiology. Symptomatic epilepsies with frontal lobe focal seizures (e.g. hypermotor seizures, seizures with affective symptomatology, versive, postural tonic seizure from suplementar motor area etc.) could be seen in various aetiology as tuberos sclerosis, cortical dysplasia, tumour etc. Myoclonic seizures could be seen in different epileptic syndromes in childhood. Atonic seizures in pseudo-Lennox syndrome represents negative epileptic myoclonus arising from frontal lobe. Atypical absences in pseudo-Lennox, Lennox–Gastaut or Doose syndrome also have frontal lobe origin. Special place take epileptic spasms in West syndrome or other epileptic encephalopathy. Tonic seizures, one of the hallmarks of Lennox–Gastatut syndrome, represents frontal lobe seizures. The most important role in generating electrical status epilepticus during non-REM sleep has frontal epileptogenic area. Complexity of frontal zone makes epilepsy diagnose challenging, being a reason for necessity of video EEG as a “gold” standard in diagnose of epilepsy.