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Epileptic Disorders : International... Dec 2004Frontal lobe epilepsy accounts for only 10-20% of the patients in surgical series, but the incidence in non-surgical patient cohorts seems to be much higher. The typical... (Review)
Review
Frontal lobe epilepsy accounts for only 10-20% of the patients in surgical series, but the incidence in non-surgical patient cohorts seems to be much higher. The typical clinical presentation of the seizures includes contralateral clonic movements, uni- or bilateral tonic motor activity as well as complex automatism. The yield of surface EEG may be limited due to the difficulty in detection of mesial or basal foci, and the patient may be misdiagnosed as having non-epileptic events. In addition, in patients with mesial frontal foci the epileptiform discharges may be mislateralized ("paradoxical lateralization"). Therefore, epilepsy surgery has been commonly considered as less promising in patients with frontal lobe epilepsy. However, the advent of sophisticated neuroimaging techniques, particularly MRI with epilepsy-specific sequences, has made it possible to delineate the epileptogenic lesion and detect a specific etiology, in an increasing number of patients. Thus, the success rate of epilepsy surgery in frontal lobe epilepsy is currently comparable to temporal lobe epilepsy, if the candidates are carefully selected. Patients with frontal lobe epilepsy who do not respond to anticonvulsive medication, and who are not eligible for epilepsy surgery may benefit from alternative approaches such as electrical brain stimulation.
Topics: Anticonvulsants; Brain Mapping; Diagnosis, Differential; Electroencephalography; Epilepsy, Frontal Lobe; Evoked Potentials; Frontal Lobe; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Prognosis; Psychosurgery; Treatment Outcome
PubMed: 15634619
DOI: No ID Found -
American Family Physician Jun 1996Middle lobe syndrome is defined as recurrent or chronic collapse of the middle lobe of the right lung. It occurs in all age groups and is divided into an obstructive... (Review)
Review
Middle lobe syndrome is defined as recurrent or chronic collapse of the middle lobe of the right lung. It occurs in all age groups and is divided into an obstructive type, with a demonstrable airway occlusion, and a nonobstructive type, with a patent right middle lobe bronchus apparent on bronchoscopy. Middle lobe collapse has specific radiographic findings. Malignancy is the most common cause of the obstructive type, and infections are the second leading etiology. The nonobstructive type is associated with inflammatory conditions and bronchiectasis. In all cases, treatment is directed at the underlying cause.
Topics: Decision Trees; Diagnosis, Differential; Humans; Middle Lobe Syndrome
PubMed: 8644568
DOI: No ID Found -
Epilepsia 1998On the basis of cytoarchitectural and functional studies, the frontal lobe can be subdivided into the primary motor cortex, premotor cortex, prefrontal cortex, and the... (Review)
Review
On the basis of cytoarchitectural and functional studies, the frontal lobe can be subdivided into the primary motor cortex, premotor cortex, prefrontal cortex, and the limbic and paralimbic cortices. However, we are still a long way from clearly identifying individual frontal lobe epilepsies. Instead, we are limited to a discussion of frontal lobe seizures arising from various regions of the frontal lobe. Supplementary motor area epilepsy and perirolandic epilepsy have been quite well defined, in contrast to syndromes involving other regions of the frontal lobe. Recent technological advances in neuroimaging, electroencephalography, magnetoencephalography and detailed videotape analysis of seizure semiology may enable us to delineate these frontal lobe syndromes with better accuracy, thereby improving outcome after epilepsy surgery.
Topics: Epilepsy, Frontal Lobe; Fluorodeoxyglucose F18; Frontal Lobe; Humans; Magnetic Resonance Imaging; Magnetoencephalography; Motor Cortex; Prefrontal Cortex; Terminology as Topic; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 9637594
DOI: 10.1111/j.1528-1157.1998.tb05126.x -
Journal of Clinical Neurophysiology :... Oct 2012Mesial frontal lobe epilepsies can be divided into epilepsies arising from the anterior cingulate gyrus and those of the supplementary sensorimotor area. They provide... (Review)
Review
Mesial frontal lobe epilepsies can be divided into epilepsies arising from the anterior cingulate gyrus and those of the supplementary sensorimotor area. They provide diagnostic challenges because they often lack lateralizing or localizing features on clinical semiology and interictal and ictal scalp electroencephalographic (EEG) recordings. A number of unique semiologic features have been described over the last decade in patients with mesial frontal lobe epilepsy (FLE). There are few reports of applying advanced neurophysiologic techniques such as electrical source imaging, magnetoencephalography, EEG/functional magnetic resonance imaging, or analysis of high-frequency oscillations in patients with mesial FLE. Despite these diagnostic challenges, it seems that patients with mesial FLE benefit from epilepsy surgery to the same extent or even better than patients with FLE do, as a whole.
Topics: Brain Mapping; Brain Waves; Electroencephalography; Epilepsy, Frontal Lobe; Female; Frontal Lobe; Humans; Magnetic Resonance Imaging; Magnetoencephalography; Male; Neurosurgical Procedures; Periodicity; Predictive Value of Tests; Treatment Outcome
PubMed: 23027093
DOI: 10.1097/WNP.0b013e31826b3c60 -
Journal of Clinical Neurophysiology :... Oct 2012Dorsolateral frontal lobe seizures often present as a diagnostic challenge. The diverse semiologies may not produce lateralizing or localizing signs and can appear... (Review)
Review
Dorsolateral frontal lobe seizures often present as a diagnostic challenge. The diverse semiologies may not produce lateralizing or localizing signs and can appear bizarre and suggest psychogenic events. Unfortunately, scalp electroencephalographic (EEG) and magnetic resonance imaging (MRI) are often unsatisfactory. It is not uncommon that these traditional diagnostic studies are either unhelpful or even misleading. In some cases, SPECT and positron emission tomography imaging can be an effective tool to identify the origin of seizures. However, these techniques and other emerging techniques all have limitations, and new approaches are needed to improve source localization.
Topics: Adult; Anticonvulsants; Brain Mapping; Brain Waves; Electroencephalography; Epilepsy, Frontal Lobe; Female; Frontal Lobe; Humans; Magnetic Resonance Imaging; Neurosurgical Procedures; Periodicity; Positron-Emission Tomography; Predictive Value of Tests; Tomography, Emission-Computed, Single-Photon; Treatment Outcome
PubMed: 23027094
DOI: 10.1097/WNP.0b013e31826b3c7c -
Ryoikibetsu Shokogun Shirizu 2002
Review
Topics: Anticonvulsants; Diagnosis, Differential; Diagnostic Imaging; Epilepsy, Temporal Lobe; Humans; Prognosis; Temporal Lobe
PubMed: 12483823
DOI: No ID Found -
Journal of Clinical Neurophysiology :... Oct 2012Neocortical temporal lobe epilepsy (NTLE) comprises a heterogeneous group of epilepsies with focal seizures characterized by auditory, somatosensory, or psychic auras... (Review)
Review
Neocortical temporal lobe epilepsy (NTLE) comprises a heterogeneous group of epilepsies with focal seizures characterized by auditory, somatosensory, or psychic auras followed by motionless staring, early contralateral clonic activity often secondarily generalizing. Neurophysiologic findings in NTLE are typically a predominance of lateral temporal interictal epileptiform activity (IEA) and an ictal onset pattern consisting of irregular, hemispheric delta slowing. Advanced neurophysiologic techniques such as EEG and magnetoencephalography source imaging can help to determine the area generating the initial and propagated interictal and ictal activities and may limit the number of patients requiring long-term invasive recordings before epilepsy surgery.
Topics: Adult; Brain Mapping; Brain Waves; Electroencephalography; Epilepsy, Temporal Lobe; Female; Humans; Magnetic Resonance Imaging; Magnetoencephalography; Neocortex; Neurosurgical Procedures; Periodicity; Predictive Value of Tests; Temporal Lobe; Treatment Outcome
PubMed: 23027092
DOI: 10.1097/WNP.0b013e31826bd78b -
Neurosurgical Review Jun 2002Frontal lobe epilepsy has been better understood during the past two decades with the advent of technologies with improved localizing capabilities. Major technological... (Review)
Review
Frontal lobe epilepsy has been better understood during the past two decades with the advent of technologies with improved localizing capabilities. Major technological advances in the ability to delineate structural and functional brain regions have led to a resurgence of interest in epilepsy surgery. Neuroimaging modalities have broadened the scope of what are now considered surgically remediable syndromes. In the following article, we attempt to review the current concepts regarding diagnosis and surgical management of frontal lobe epilepsy.
Topics: Epilepsy, Frontal Lobe; Frontal Lobe; Humans; Neurosurgical Procedures
PubMed: 12135227
DOI: 10.1007/s101430100174 -
Trends in Neurosciences Aug 1988
Review
Topics: Frontal Lobe; Humans; Schizophrenia
PubMed: 2469198
DOI: 10.1016/0166-2236(88)90060-4 -
Neurology Jun 1996Photic-induced seizures are usually generalized. There are several cases of focal seizures reported, and all have been shown to arise from the visual cortex. We report... (Review)
Review
Photic-induced seizures are usually generalized. There are several cases of focal seizures reported, and all have been shown to arise from the visual cortex. We report an unusual case of temporal lobe epilepsy, supported by electroclinical data and confirmed by a successful temporal lobectomy, with seizures induced by photic stimulation.
Topics: Adult; Craniocerebral Trauma; Electroencephalography; Epilepsy, Temporal Lobe; Female; Hippocampus; Humans; Kindling, Neurologic; Occipital Lobe; Photic Stimulation; Temporal Lobe
PubMed: 8649544
DOI: 10.1212/wnl.46.6.1540