Abstract

INTRODUCTION

John Hughlings Jackson reflected that the frontal lobe is the brain’s ‘most complex and least organized centre’ (Jackson 1931) and, despite subsequent advances in neuroscience, even by the late 20th century the frontal lobe was still considered to be an ‘uncharted province of the brain’ (Goldman-Rakic 1984). For epileptologists today, frontal lobe epilepsy (FLE) remains the most challenging of all the epilepsies, both in terms of understanding how seizures are organized and how they should be treated. This is very evident in comparison to the now well-defined syndrome of mesial temporal lobe epilepsy (TLE).

Important advances have been made in recent decades, especially in correlations between the clinical and electrical expression of seizures, permitting better understanding of FLE. Together with major developments in the field of neuroimaging, these advances are changing the approach to management, particularly in making curative surgery a real possibility for many more patients than ever