A Multicultural Assessment of Frontal Lobe Epilepsy

Hundreds of clinicians and health care providers from around the world gathered for a Spanish symposium on frontal lobe epilepsy, held during the American Epilepsy Society (AES) 2015 Annual Meeting in Philadelphia, to learn more about treatment options for the condition.

The group discussion, presented in Spanish, provided an overview of frontal lobe epilepsy, particularly the clinical semiology of seizures and comorbidities associated with intractable cases. The forum gave special reference to the neuropsychological aspects of frontal lobe epilepsy, which affect quality of life, including social and psychological development, in people with epilepsy.

Andres M. Kanner, MD, who is considered by many to be one of the world’s leading researchers on the behavioral aspects of epilepsy, discussed the psychiatric and neuropsychological aspects of frontal lobe epilepsy.

As the chief of the epilepsy division at the Miller School of Medicine at University of Miami, Dr. Kanner said that although psychiatric comorbidities are relatively common in patients with frontal lobe epilepsy, they are not specific to the condition. Examples of such psychiatric issues, he said, include attention deficit disorders, mood and anxiety disorders, and impulsive control disorders.

Similarly, Dr. Kanner explained that frontal lobe epilepsy may also be associated with characteristic cognitive disturbances, such as memory and verbal fluency, social cognition, and concept formation. However, he said these types of conditions may be identified in patients with other types of epilepsy as well.

He mentioned that, unlike temporal lobe epilepsy, frontal lobe epilepsy does not have a different impact on the verbal and visual mediated functions relative to the side of the epileptogenic area of the brain, nor does it affect the intelligence quotient of those with the condition. Furthermore, he said, the neuropsychological deficits of individuals with frontal lobe epilepsy do not correlate with the age of onset, duration of seizure disorder, or the severity of seizures.

Another global epilepsy expert, Jaime Parra, MD, from Madrid, Spain, shared his expertise regarding the semiology of frontal lobe seizures.

“Semiologic features in frontal lobe seizures depend neither on the anatomical origin of the ictal discharge nor the target areas of its propagation, alone, but on the dynamic interaction between both of them and are highly reproducible in an individual patient,” said Dr. Parra.

He further explained that the semiology of frontal lobe seizures follow “a propagation of the ictal discharge in a rostral-to-caudal axis.” No organization is clarified for the medial-lateral axis just yet, he said.

The AES 2015 Annual Meeting was held December 4-8 in Philadelphia.

Session: SUDEP: Spanish Symposium: Frontal Lobe Epilepsy. Dec. 4, 2015.