FRONTAL-LOBE SEIZURES - ELECTROCLINICAL SYNDROMES

To define further the electroclinical manifestations of frontal lobe e pilepsy (FLE), we studied 150 seizures manifested by 24 patients; 18 p atients had subdural electrode arrays (SEA). The findings in these pat ients clearly overlapped presumably reflecting the interconnections be tween functionally related frontal zones; yet the manner in which the symptoms clustered and the sequence in which they occurred generally i ndicated the anatomic site of the epileptogenic zone. We divided the p atients into three major groups: (a) those with supplementary motor se izures, (b) those with focal motor seizures, and (c) those with comple x partial seizures (CPS, psychomotor seizures). Supplementary motor se izures began with tonic posturing of the extremities. Focal motor seiz ures generally began with conscious contralateral version or unilatera l clonic focal motor activity; tonic posturing was noted only late in the seizure. CPS (psychomotor) began with unresponsiveness at onset, f ollowed by staring or unconscious contraversion. We compared frontal l obe seizures with temporal lobe seizures reported previously; oral-ali mentary automatisms, repetitive hand movements, or looking around, wer e more common in temporal lobe seizures, whereas tonic posturing and b icycling movements were more common in frontal lobe psychomotor seizur es.