Temporal Lobe Seizure

1 What is Temporal Lobe Seizure?

According to the name these seizures originate in the temporal lobes of human brain.

The main function of temporal lobe is to process emotions and it is useful for short-term memory. Some symptoms of temporal lobe seizures may include feelings such as euphoria, déjà vu or fear. During temporal lobe seizure person is aware of what is happening around him. During more intense seizures person might look awake but is unresponsive. Hands and lips make purposeless, repetitive movements.  

The reason of temporal lobe seizure is anatomical defect of scar in the temporal lobe but the cause is often unknown.  Treatment of temporal lobe seizures is done with medications but for people who won’t respond to medications surgery is the only option left for them. 

2 Symptoms

There are several signs and symptoms of temporal lobe seizure

An unusual sensation may precede a temporal lobe lesion acting as a warning. Not everyone with temporal lobe seizures experience this unusual feeling. This is a simple partial focal seizure- one that doesn’t impair consciousness they include. A sudden sense of unprovoked fear. A feeling that what is happening has happened before called as déjà vu experience. Sudden change of odor or taste, and feeling of raising in the abdomen. Sometimes temporal lobe seizures disable the ability to respond to others. this type of temporal lobe seizures usually last from 30 seconds to 3 minutes longer.

Common symptoms include:

  • loss of awareness of surroundings,
  • staring,
  • lip smacking,
  • repeated swallowing or chewing,
  • unusual figure moments, such as picking motions.

After temporal seizure there is difficulty speaking and confusion, inability to recall what happened during the seizure, unawareness of having had seizure and extreme sleepiness.

In extreme cases this seizure turns out into tonic- clonic  featuring convulsions and  loss of consciousness.

3 Causes

The main cause of the temporal lobe seizure is unknown. It can be result of number of factors:

  • traumatic injury to brain,
  • infections such as encephalitis and meningitis,
  • blood vessel malformations in the brain,
  • stroke,
  • brain tumors,
  • genetic syndrome,
  • gliosis scaring of the part of the temporal lobe.  

While doing daily normal activities our brain cells produce numerous electrical impulses. When these electrical impulses become unsynchronized they form convulsions or seizures. If this happens at a particular area, then it will be called as focal seizure. A temporal lobe seizure is a partial seizure originating from one of the temporal lobes.

4 Making a Diagnosis

Tests and diagnosis of temporal lobe seizures depends on:

  • Neurological exam:  
    • reflexes,
    • muscle tone,
    • muscle strength,
    • sensory function,
    • gait,
    • posture,
    • coordination,
    • balance.

Doctor may also ask questions to assess the thinking of patient.

  • Blood tests and scans- blood tests may be recommended to check for the presence of triggers in the blood.
  • Electroencephalogram (EEG): electrodes are attached to the scalp to monitor electrical activity of brain.  People with epilepsy often have change in their brain wave patterns.  The changes in encephalogram can be noted to have further conclusion about disease. Sometimes EEG can indicate the type of seizure.
  • Magnetic resonance imaging (MRI)- an imaging technique which includes usage of electromagnetic waves. Certain MRI abnormality may provide a clue to the cause of seizure. Single photon emission computerized tomography. Sometimes used when the area of seizure onset is unclear, SPECT imaging requires two scans – one during seizure and the other one – during normal condition. Radioactive material is injected into both of the scans. the scans are then compared to find the area of brain with greatest activity during the seizure. The resulting image is superimposed in to the MRI this is used with EEG information to help guide surgeons.

5 Treatment

There are many medications to treat temporal lobe seizures. Seizure control cannot be achieved with medicines alone, and side effects such as weight gain, fatigue, dizziness are common. These side effects must be kept in mind before starting drug therapy.

  • Surgery is helpful in those people who don’t respond to drug therapy. After surgery in some people symptoms of seizures are gone or reduce significantly. Surgery has its own risks. It may not be successful and may end up causing major neurological problems. Surgery cannot be done in the following cases:
    • if the focus of seizure is from the region of brain which performs vital functions,
    • if the focus of seizure is not one location, focus of the seizure can’t be identified.
  • Vagus nerve stimulation- a device called vagus nerve stimulator can be an option for treatment. This device stimulates the vagus nerve. It is connected with vagus nerve and implanted on chest under collar bone. The device turns on and off according to the adjusted program and can be activated by a magnet.  
  • Responsive neurostimulation- Food and Drug administration has approved a device for treating seizures in people who do not respond to drug therapy.  The device is implanted in the skull and a battery is connected to it. Whenever it detects a seizure it sends a small electrical impulse to brain.
  • Deep brain stimulation- in this process they implant electrodes into the brain. The area of the brain is called thalamus in to which electrodes are inserted.  
  • Pregnancy and seizures-  women who are on medications for seizures usually have healthy babies. However, some medicine such as valproic acid can increase the risk of complications during the birth. Seizure while pregnancy can pose risk to baby so it is not recommended not to stop taking drugs during the pregnancy.
  • Contraception with seizures- some anti-seizure medicines increase the metabolism of contraceptive medications and eliminate them before they act. So one must keep this in mind while taking these both medications simultaneously.

6 Prevention

Meditation acupuncture stress free life can prevent temporal lobe seizure. 

7 Lifestyle and Coping

Temporal lobe seizures can affect lifestyle of a person by mental stress and unusual behavior, and people don’t recognize unusual behavior as seizure.

Children may get teased or embarrassed because of this condition. And living with a constant threat of another seizure may frustrate people.

Talking with other people suffering from the same disease may be helpful.

One might share their experiences, advices and tips with each other.

The epilepsy foundation has a network for support group and inline forums.

Asking doctors for any support groups in the nearby area will help. 

8 Risks and Complications

There are several complications associated with temporal lobe seizure.

Over time, repeated temporal lobe seizures can cause the part of the brain responsible for learning and memory which is called as hippocampus to shrink. Shrinkage of hippocampus decreases the cognitive power of brain.

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