Epilepsy Syndromes Temporal Lobe

Temporal lobe epilepsy is a common form of epilepsy that is characterized by abnormal brain activity in the temporal lobes (ear-level regions on either side of the head), leading to seizures. The temporal lobes are associated with:

  • Language
  • Memory
  • Smell
  • Sound.

Temporal lobe seizures can be either simple partial or complex partial seizures.

What Causes Temporal Lobe Epilepsy?

Temporal lobe epilepsy is a symptomatic partial epilepsy syndrome, which means that there’s usually an obvious cause for the disorder. Onset may be attributed to:

  • A brain tumor
  • A malformation in the brain
  • Brain damage due to an infection (i.e. encephalitis or meningitis)
  • Genetic inheritance
  • Previous asphyxiation that resulted in brain damage
  • Severe head injury
  • Stroke.

What Does Temporal Lobe Epilepsy Look Like?

An individual with temporal lobe epilepsy will likely experience both simple partial seizures (individual remains conscious) and complex partial seizures (individual loses consciousness). Temporal lobe epilepsy symptoms are difficult to categorize because each individual experience will vary from one person to the next in terms of the intensity and sensations experienced during the seizure.

Many individuals with temporal lobe seizures experience a simple partial seizure before a complex partial seizure. These “warning seizures” are more commonly known as “auras.” Auras are peculiar sensations that occur just before a seizure. They are widely varied, but an individual will usually experience the same sensations each time. During an aura, a person may experience:

  • Déjà vu (experience seems familiar)
  • Flashbacks to memories of past events and people
  • Increased heart rate
  • Jamais vu (the feeling of an unfamiliar experience)
  • Nausea
  • Strange (imaginary) sights, sounds, smells (such as burnt rubber) or tastes
  • Strong, inexplicable emotions (i.e. anxiety, fear, happiness, sadness)
  • Sweating and/or flushed skin
  • The sense that he, or his environment, is unreal.

Whether preceded by an aura or not, complex partial seizures are the most common type of temporal lobe seizure. These are characterized by automatisms (repetitive, unconscious actions). Some common automatisms include:

  • Aimless wandering
  • Blank staring (not a true automatism)
  • Chewing
  • Fidgeting
  • Head scratching
  • Lip smacking
  • Picking at clothing
  • Rubbing hands together
  • Swallowing.

Temporal lobe seizures typically last no longer than a few minutes. Afterwards, the individual will probably be very confused and will likely remember very little of what happened during the seizure.

According to the Mayo Foundation for Medical Education and Research, approximately 50 percent of individuals who experience temporal lobe seizures will develop generalized tonic-clonic (convulsive) seizures. Minor memory problems may also develop as a result of damage due to repeated temporal lobe seizures.

What’s the Prognosis for Temporal Lobe Epilepsy?

Approximately 60 to 70 percent of individuals are able to successfully control their seizures with antiepileptic medication. Medication may be less effective against some temporal lobe seizures that result from a permanent defect in the temporal lobe area. In such cases, surgery may be necessary to remove the affected area.

Resources

Donner, E. J et al. (2006). Temporal lobe epilepsies. Retrieved March 24, 2010, from http://www.aboutkidshealth.ca/Epilepsy/Temporal-Lobe-Epilepsies.aspx?articleID=6990