Frontal lobe epilepsy is an episodic neurological disorder characterised by recurrent seizures arising from one or both frontal lobes. Seizures may appear atypical and are easily misdiagnosed in the emergency department as nonepileptic attacks (psychological episodes) or parasomnias (sleep disorders). Given the multiple connections and functions of the frontal lobes, Frontal lobe epilepsy presentations are highly variable, including motor, psychic, behavioral or cognitive changes, with a wide differential diagnosis. Prompt diagnosis in the busy emergency department may be difficult, because of complex, often multiple but brief episodes, and sometimes bizarre manifestations; frequent nocturnal presentation, and a wide range of aetiologies. This narrative review summarises clinical and investigation features that help clinicians to reach an accurate and prompt diagnosis.