What are the EEG changes characteristic of frontal lobe epilepsy?

Updated: Oct 01, 2020
  • Author: Raj D Sheth, MD; Chief Editor: Selim R Benbadis, MD  more...
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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 Electroencephalogram demonstrating a right frontal lobe seizure (beginning); rhythmic 2-3 Hz activity (maximal Fp2).
Electroencephalogram demonstrating a right frontal Electroencephalogram demonstrating a right frontal lobe seizure (maximal Fp2) (end).

Example 2

Electroencephalogram demonstrating a right frontal Electroencephalogram demonstrating a right frontal lobe seizure (beginning); repetitive ~3 Hz sharp waves (maximal F4/F8).
Electroencephalogram demonstrating a right frontal Electroencephalogram demonstrating a right frontal lobe seizure (middle); repetitive ~3 Hz sharp waves (maximal F4/F8).
Electroencephalogram demonstrating a right frontal Electroencephalogram demonstrating a right frontal lobe seizure (end); rhythmic sharply contoured ~2 Hz bi-frontal delta activity.

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