frontal lobe seizures 3yo

[momsaidno]

My 3yo son has been having several seizures daily for 6 months. A recent VEEG showed they were complex partial coming from frontal lobe unilaterally.What is % of children outgrowing this type of seizure? Is keto diet effective for this type? What is prognosis of surgery on frontal lobe? At what age do children not recover as well -speech- from surgery?
His speech is slightly delayed, especially receptive speech, but his expressive speech has made great improvement with therapist.
HIs motor skills seem fine, and in every other respect he seems like a normal boy, most people dont even regognize sz as such, they are very fast and no post ictal, very non disruptive to him.
He was on Topamax for 10 weeks, increased up to 75mg day, sz slowed but didnt go away, we tapered quickly off after rash appeared. The sz DIDNT increase again and he was off med for 1 month before VEEG and Trileptal was started 150mg twice daily. NO response so far. Do you think Topamax was decreasing sz if they didnt rebound after drug ended?
Thank you for all your help. April

[CCF-Neuro-M.D.-CS]

From what you have described, your son has focal epilepsy arising from the frontal lobe. Focal seizures do not typically go away over time because they are typically do to an underlying structural problem. Did your son have an MRI? If he is has not, he should. It should be a special epilepsy protocol looking at the frontal lobes. Even if there is no major malformation within the frontal lobe, there is most likely a small microscopic abnormality.

The ketogenic diet is typically used early in the course of children with forms of generalized epilepsy. It has been used in focal epilepsy, but is not as well studied. It can typically be viewed as another medication, or medication alternative.

Regarding surgery, the outcome from surgery in the frontal lobe depends upon where language is and how close to the motor cortex the surgery is being planned. Language is typically in the left hemisphere, however it would have to be confirmed with testing. If a surgery is in the non-dominant (side without language) lobe and away from the motor strip then no significant long term deficits should be present.

If you are considering surgery, a second opinion at a large epilepsy center such as the Cleveland Clinic would be reasonable. We have 4 wonderful pediatric epilepsy doctors and a fantastic epilepsy surgeon. A second opinion could provide you answers regarding surgery and medical therapy. We perform this type of consultation several times per week. Good luck.

[momsaidno]

Sorry, I was mistaken, the seizures didnt show unilaterally, the report just says frontal lobe.
Also do complex partials eventually always secondarily generalize? Or is it possible for them to stay like they are forever? Thanks

[lookatmystealth]

Hi!  I just wanted to let you know about a site I use alot.  www.epilepsyfoundation.org  Go to the Parents helping Parents Forum and post as many questions as you like.  You will get very informative answers from people who have been where you are now.  It really helps!

[cmgm]

Hi,
I am an SLP working with a 2 1/2 old little girl with a history of seizure activity in the left frontal lobe.
Her expressive speech is delayed, she primarily uses sign language and some verbal approximations to communivcate.
I'm looking for information on the relationship of the seizures to her speech, as well as information on treatment approaches.
Thanks.

[momsaidno]

cmgm-I have since found out Noahs sz arise from left frontal lobe-apparently due to some heterotopic gray matter (gray matter in the wrong place, got stuck in white matter).When he started speech therapy 5 months ago, he picked up some sign language and progressed rapidly with his expressive speech, receptive still isnt so good, perhaps due to subclinical sz activity. I cant help you too much, it just depends where in brain or lobe sz occurs as to how behavior or speech is affected. Control the sz and if nothing else is wrong, hopefully she can catch up. Good luck April

[shirleyM]

I am a 63 year old woman and I have been diagnosed with frontal lobe seizures. Can you tell me more about it? I appriecate your help.Thanks

[momsaidno]

Shirley- there are so many variables, but in general when one section of brain is affected, it causes partial sz, either simple partial or complex partial. In complex partial, there is some affect on consciousness, either you are somewhat aware of whats going on or you are completely out. Partial sz can secondarily generalize, that is , spread to entire brain, causing a grand-mal (tonic-clonic) sz or stiffening and/or jerking of whole body. Partial sz can affect many different things, they can be just a smell or feeling or one tiny area like a finger twitching. Or they can cause someone to wander around aimlessly, picking at clothes or saying something that makes no sense, over and over. I will try to post an excellent article on frontal lobe sz I found for you. Or link, anyway.
April
http://author.emedicine.com/NEURO/topic141.htm

There, did it!!
If you would like to talk more, email me at
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Good luck to you!