Frontal Lobe Epilepsy Differential Diagnoses

  • Author: Sheryl Haut, MD; Chief Editor: Selim R Benbadis, MD   more...
 
Updated: May 24, 2011
 
 

Diagnostic Considerations

Patients with frontal lobe seizures may present with a clear epileptic syndrome or with unusual behavioral or motor manifestations that are not immediately recognizable as seizures.[7, 8]

As previously mentioned, it is difficult to distinguish frontal lobe seizures from nonepileptic events based on history alone, and patients with frontal lobe epilepsy are often directed first to psychiatrists rather than to neurologists.

Another condition that should be considered is nocturnal paroxysmal dystonia, although it is unclear if this represents an independent entity.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Sheryl Haut, MD  Associate Professor of Clinical Neurology, Program Director, Neurology Residency Training Program, Albert Einstein College of Medicine; Director, Adult Epilepsy, Montefiore Medical Center

Sheryl Haut, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and American Neurological Association

Disclosure: Jazz Consulting fee Consulting; Endo Grant/research funds Research; Acorda Consulting fee Consulting; Vivus Consulting fee Consulting

Specialty Editor Board

Edward B Bromfield, MD  Associate Professor of Neurology, Faculty Member, Division of Sleep Medicine, Harvard Medical School; Chief, Division of EEG, Epilepsy and Sleep Neurology, Consulting Neurologist, Brigham and Women's Hospital

Edward B Bromfield, MD is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, American Neurological Association, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: eMedicine Salary Employment

Jose E Cavazos, MD, PhD, FAAN  Associate Professor with Tenure, Departments of Neurology, Pharmacology, and Physiology, Program Director of the Clinical Neurophysiology Fellowship, University of Texas School of Medicine at San Antonio; Co-Director, South Texas Comprehensive Epilepsy Center, University Hospital System; Director of the San Antonio Veterans Affairs Epilepsy Center of Excellence and Neurodiagnostic Centers, Audie L Murphy Veterans Affairs Medical Center

Jose E Cavazos, MD, PhD, FAAN is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and American Neurological Association

Disclosure: GXC Global, Inc. Intellectual property rights Medical Director - company is to develop a seizure detecting device. No conflict with any of the eMedicine articles that I wrote or edited.

Chief Editor

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

References

  1. Picard F, Bruel D, Servent D, et al. Alteration of the in vivo nicotinic receptor density in ADNFLE patients: a PET study. Brain. Aug 2006;129(Pt 8):2047-60. [Medline].

  2. Brodtkorb E, Picard F. Tobacco habits modulate autosomal dominant nocturnal frontal lobe epilepsy. Epilepsy Behav. Nov 2006;9(3):515-520. [Medline].

  3. Fedi M, Berkovic SF, Scheffer IE, O'Keefe G, Marini C, Mulligan R, et al. Reduced striatal D1 receptor binding in autosomal dominant nocturnal frontal lobe epilepsy. Neurology. Sep 9 2008;71(11):795-8. [Medline].

  4. O'Brien TJ, Mosewich RK, Britton JW, Cascino GD, So EL. History and seizure semiology in distinguishing frontal lobe seizures and temporal lobe seizures. Epilepsy Res. Dec 2008;82(2-3):177-82. [Medline].

  5. So NK. Mesial frontal epilepsy. Epilepsia. 1998;39 Suppl 4:S49-61. [Medline].

  6. Kotagal P, Arunkumar GS. Lateral frontal lobe seizures. Epilepsia. 1998;39 Suppl 4:S62-8. [Medline].

  7. Williamson PD, Spencer DD, Spencer SS, Novelly RA, Mattson RH. Complex partial seizures of frontal lobe origin. Ann Neurol. Oct 1985;18(4):497-504. [Medline].

  8. Laskowitz DT, Sperling MR, French JA, O'Connor MJ. The syndrome of frontal lobe epilepsy: characteristics and surgical management. Neurology. Apr 1995;45(4):780-7. [Medline].

  9. Knake S, Triantafyllou C, Wald LL, Wiggins G, Kirk GP, Larsson PG, et al. 3T phased array MRI improves the presurgical evaluation in focal epilepsies: a prospective study. Neurology. Oct 11 2005;65(7):1026-31. [Medline].

  10. Bonelli SB, Lurger S, Zimprich F, Stogmann E, Assem-Hilger E, Baumgartner C. Clinical seizure lateralization in frontal lobe epilepsy. Epilepsia. Mar 2007;48(3):517-23. [Medline].

  11. Mosewich RK, So EL, O'Brien TJ, Cascino GD, Sharbrough FW, Marsh WR, et al. Factors predictive of the outcome of frontal lobe epilepsy surgery. Epilepsia. Jul 2000;41(7):843-9. [Medline].

  12. Elsharkawy AE, Alabbasi AH, Pannek H, Schulz R, Hoppe M, Pahs G, et al. Outcome of frontal lobe epilepsy surgery in adults. Epilepsy Res. Oct 2008;81(2-3):97-106. [Medline].

  13. Jeha LE, Najm I, Bingaman W, Dinner D, Widdess-Walsh P, Lüders H. Surgical outcome and prognostic factors of frontal lobe epilepsy surgery. Brain. Feb 2007;130:574-84. [Medline].

  14. Kossoff EH, Rowley H, Sinha SR, Vining EP. A prospective study of the modified Atkins diet for intractable epilepsy in adults. Epilepsia. Feb 2008;49(2):316-9. [Medline].

 
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