Answer
Answer
Frontal lobe seizures are more rare and represent about one quarter of focal epilepsies. On EEG, they are difficult to localize due to their often rapid spread and are often normal, especially if they have onset in the mesial frontal lobe. When the EEG is abnormal, it may show frontal spikes or sharp waves (unilateral or bilateral). Seizures typically occur during sleep, although EEG during sleep shows normal sleep architecture interictally.
Example 1
Electroencephalogram demonstrating a right frontal lobe seizure (beginning); rhythmic 2-3 Hz activity (maximal Fp2).
Electroencephalogram demonstrating a right frontal lobe seizure (maximal Fp2) (end).
Example 2
Electroencephalogram demonstrating a right frontal lobe seizure (beginning); repetitive ~3 Hz sharp waves (maximal F4/F8).
Electroencephalogram demonstrating a right frontal lobe seizure (middle); repetitive ~3 Hz sharp waves (maximal F4/F8).
Electroencephalogram demonstrating a right frontal lobe seizure (end); rhythmic sharply contoured ~2 Hz bi-frontal delta activity.
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Media Gallery
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Electroencephalogram demonstrating hypsarrhythmia in infantile spasms. Note the chaotic high-amplitude background.
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Electroencephalogram demonstrating hypsarrhythmia. Note the electrodecremental response that is associated with a spasm in infantile spasms (ie, West syndrome).
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Slow (< 2.5 Hz) electroencephalographic spike and wave discharges associated with atypical absence seizures (ie, Lennox-Gastaut syndrome).
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Slow (< 2.5 Hz) electroencephalographic spike and wave discharges in atypical absence epilepsy (ie, Lennox-Gastaut syndrome).
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Typical 3-Hz electroencephalographic spike and wave discharges seen in absence epilepsy.
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Electroencephalogram demonstrating absence epilepsy. Anteriorly dominant, typical 3-Hz spike and wave discharges.
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Benign rolandic epilepsy associated with typical centrotemporal electroencephalographic spikes.
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Electroencephalogram demonstrating benign rolandic epilepsy. Note the characteristic spike and waves seen in drowsiness.
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Electroencephalogram demonstrating polyspike and wave discharges seen in juvenile myoclonic epilepsy.
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Electroencephalogram demonstrating polyspike and wave response produced by photic stimulation.
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Electroencephalogram demonstrating polyspike and wave discharges, which can be seen in idiopathic generalized epilepsy.
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Electroencephalogram demonstrating paroxysmal fast activity as can be seen in Lennox-Gastaut syndrome.
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Electroencephalogram demonstrating interictal pattern (sharp waves) in left temporal lobe epilepsy.
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Electroencephalogram demonstrating interictal pattern of independent left and right temporal sharp waves, which can be seen in temporal lobe epilepsy.
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Electroencephalogram demonstrating a left temporal lobe seizure (beginning) with 2-3 Hz rhythmic delta activity.
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Electroencephalogram demonstrating a left temporal lobe seizure (middle), evolving to rhythmic theta activity.
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Electroencephalogram demonstrating a left temporal lobe seizure (end), further evolving to diffuse delta activity prior to abrupt cessation.
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Electroencephalogram of a right occipital lobe seizure (beginning); 4-5 Hz repetitive sharp waves (maximal T6/O2).
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Electroencephalogram demonstrating spike-wave complexes as can be seen in idiopathic generalized epilepsy.
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Electroencephalogram demonstrating right temporal lobe seizure (beginning); rhythmic delta activity evolving to rhythmic theta activity over the right temporal region.
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Electroencephalogram demonstrating a right temporal lobe seizure (middle); continued right temporal rhythmic theta activity.
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Electroencephalogram demonstrating a right temporal lobe seizure (end), resolution of right temporal rhythmic theta.
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Electroencephalogram demonstrating interictal pattern of extratemporal spikes (left hemispheric spike and wave).
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Electroencephalogram demonstrating interictal pattern of extratemporal spikes (right posterior spikes, temporoparietal).
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Electroencephalogram demonstrating interictal pattern of extratemporal spikes (left posterior spikes, temporoparietal).
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Electroencephalogram demonstrating repetitive central spikes (maximal Cz).
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Electroencephalogram demonstrating repetitive central sharp waves (maximal Cz).
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Electroencephalogram demonstrating repetitive left frontocentral sharp waves (maximal Cz).
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Electroencephalogram demonstrating a left fronto-central seizure (beginning); rhythmic 14-16 Hz activity (maximal Cz and C3).
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Electroencephalogram demonstrating a left fronto-central seizure (end); evolution to rhythmic 11-12 Hz activity with slightly higher amplitude with abrupt cessation.
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Electroencephalogram demonstrating a right frontal lobe seizure (beginning); rhythmic 2-3 Hz activity (maximal Fp2).
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Electroencephalogram demonstrating a right frontal lobe seizure (maximal Fp2) (end).
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Electroencephalogram demonstrating a right frontal lobe seizure (beginning); repetitive ~3 Hz sharp waves (maximal F4/F8).
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Electroencephalogram demonstrating a right frontal lobe seizure (middle); repetitive ~3 Hz sharp waves (maximal F4/F8).
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Electroencephalogram demonstrating a right frontal lobe seizure (end); rhythmic sharply contoured ~2 Hz bi-frontal delta activity.
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Electroencephalogram of a right occipital lobe seizure (middle); repetitive sharp waves evolve to rhythmic theta in the right occipital region.
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Electroencephalogram of a right occipital lobe seizure (end); obscured by EMG artifact.
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Electroencephalogram demonstrating a run of generalized polyspikes, which are more left predominant and can be seen in idiopathic generalized epilepsies.
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Typical absence seizure with 3-4 Hz rhythmic generalized spike and wave discharges with abrupt onset and end.
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Electroencephalogram demonstrates bilateral repetitive occipital sharp waves ~1Hz frequency.
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