Look What You Started

Epilepsy is a complex, neurological disorder marked by two or more unprovoked seizures. Understanding which area of the brain triggers these seizures is key, as it helps your healthcare provider pinpoint the most effective treatment strategies. Generally, seizures are classified into two primary groups: focal (originating in one specific brain region) and generalized (affecting both sides of the brain). A ”Seizure Focus” is the place seizures begin in your brain. Your brain consists of four main lobes that are mirrored on both sides of the brain. During a focal seizure, electrical activity can occur in any lobe, but during a generalized seizure, seizure activity involves all of the lobes. ( how thoughtful ! ) A focal seizure may begin in one area of the brain, and spread to others, and cause a number of symptoms. The symptoms of a focal seizure worsen, depending upon how much of the brain was involved. Sometimes, focal seizures may even spread to the entire brain, causing tonic-clonic seizures. The most common areas of the brain you may find focal seizures are the temporal lobe and the frontal lobe. The frontal lobe is at the front of your brain. This lobe is a very complex lobe, controlling problem solving, planning, reasoning, and speech and movement.  Your temporal lobe, although the most common seizure focus, is an extremely important lobe. The temporal lobe is on the side of your brain, mirroring one another. This lobe plays an important part in processing sound and emotion, understanding language, recognizing faces, and is home of the hippocampus, which is essential for long-term memory and learning.The back of your brain contains the occipital lobe. This lobe processes sight and any information sent from your eyes. The parietal lobe is at the top of your brain and is responsible for perception and awareness of your body and surroundings. Combining information from each of your senses, it coordinates movements in response. Regions of the brain that are specialized for learning and memory , such as the hippocampus are more prone to seizures. Frontal lobe seizures act differently depending on exactly where they begin. Seizures originating in the primary motor area have early motor manifestations,causing jerking movements right away. These may occur during sleep, lacking a post-ictal phase. The jerking often starts on one side of the face, spreads to the arm, and can prevent you from speaking. Frontal eye field seizures will cause your eyes to suddenly turn hard to one side (like you’re forced to look left or right). Seizures that take place in the Broca’s area (speech area) cause the sudden inability to understand or produce speech. Seizures in the premotor area represent versive seizures with forced head turn to one side (like someone is pushing it.) Overall, frontal lobe seizures often show up as: jerking on one side of the body, stiffening of arms/legs (on one or both sides) or strange, automatic movements (like fidgeting, walking in circles, or repeating actions) without realizing it.  You may find that your seizures stem from a brain region that may be safely altered. In such cases, your physician could suggest resective surgery (removing the affected area), or laser ablation (using laser-generated heat to eliminate it). On the other-hand, seizures may start in a critical area involved in speech, movement, or memory. Knowing the source of your seizures can help pinpoint the location of electrical misfiring and guide your doctor to a correct, precise diagnosis and effective treatment.