Treatment

Over the past decade, treatment options have increased for frontal lobe seizures. There are newer types of anti-seizure medications as well as a variety of surgical procedures that might help if medications don't work.

Medications

All anti-seizure drugs seem to work equally well at controlling frontal lobe seizures, but not everyone becomes seizure-free on medication. Your doctor might try different types of anti-seizure drugs or have you take a combination of drugs to control your seizures. Researchers are continuing to look for new and more-effective medications.

Surgery

If your seizures can't be controlled with medications, surgery might be an option. Surgery involves pinpointing the areas of the brain where seizures occur.

Two newer imaging techniques — single-photon emission computerized tomography (SPECT) and subtraction ictal SPECT coregistered to MRI (SISCOM) — can help identify the area generating seizures.

Another imaging technique, known as brain mapping, is commonly used before epilepsy surgery. Brain mapping involves implanting electrodes into an area of the brain and using electrical stimulation to determine whether that area has an important function, which would rule out surgery on that area. In addition, functional MRI (fMRI) is used to map the language area of the brain.

If you have surgery for your frontal lobe seizures, you're likely to continue to need anti-seizure medication after the surgery, although possibly at a lower dose.

Surgery for epilepsy might involve:

• Removing the focal point. If your seizures always begin in one spot in your brain, removing that small portion of brain tissue might reduce or eliminate your seizures.
• Isolating the focal point. If the portion of the brain that's causing seizures is too vital to remove, surgeons might make a series of cuts to help isolate that section of the brain. This prevents seizures from moving into other parts of the brain.
• Stimulating the vagus nerve. This involves implanting a device — similar to a cardiac pacemaker — to stimulate your vagus nerve. This procedure usually reduces the number of seizures.
• Responding to a seizure. A responsive neurostimulator is a newer type of implanted device. It is activated only when you begin to have a seizure, and it stops the seizure from occurring.
• Deep brain stimulation (DBS). This newer procedure involves implanting an electrode into your brain that's connected to a stimulating device, similar to a cardiac pacemaker, which is placed under the skin of your chest. The device sends signals to the electrode to stop signals that trigger a seizure.