Seizure - temporal lobe

Definition

This type of seizure involves a temporary movement disturbance that often involves a change in a person's behavior, unusual sensations, or various other symptoms. It arises from abnormal electrical activity in the temporal lobe on one or both sides of the brain.

Alternative Names

TLE; Seizure - temporal lobe

Causes

A seizure is an episode of abnormal electrical activity in the brain that can involve loss of consciousness or reduction of consciousness, involuntary movements, and overwhelming sensations.

Temporal lobe seizures can affect people of any age, and can occur as a single episode or can be repeated as part of a chronic (ongoing) condition. (See seizure disorder).

Information in the brain is transmitted from nerve cell to nerve cell by an electrochemical process. Certain patterns of electrical activity can cause seizures, which are episodes during which electrical signals spread in abnormal patterns within the brain. This process can be detected by an electroencephalograph (EEG).

Given the right conditions (such as exposure to certain drugs, high fever, or electrical stimulation), anyone can have a seizure.

Temporal lobe seizures commonly result from damage to specific areas in the temporal lobe of the brain. This damage includes scarring, called mesial temporal sclerosis. Causes can include traumatic injury, infection, damage to a portion of the temporal lobe due to lack of oxygen, brain tumors, genetic syndromes, and lesions of any sort.

Because the temporal lobe is involved in processing emotion and sensations, seizures in this area may begin with feelings of fear, feelings of joy (sometimes with religious associations and the sensation of a "presence"), recall of certain music, or smells and other unusual symptoms.

Symptoms

The early warning symptoms (called an aura) include:

During the seizure:

Movement disturbances include: Abnormal sensations include: Autonomic symptoms include: Other symptoms include:

Exams and Tests

Diagnosis of temporal lobe seizure is suspected primarily on the basis of the symptoms presented and the results of tests. Diagnosis may include a complete physical examination, including a detailed neuromuscular examination, which may or may not be normal.

Treatment

The goals of treatment are to perform emergency measures, if necessary, and to reduce the rate of future seizures.

Emergency treatment may not be required, unless the seizure becomes generalized or consciousness is lost. First-aid measures should be performed as appropriate, including protection from injury, prevention of breathing vomit or mucus into the lungs, and airway protection or assistance with breathing.

Record details of the seizure and report them to the health care provider. Important details include date and time of the seizure, how long it lasted, which body parts were affected, type of movements or other symptoms, possible causes and other factors which provide information about the episode (such as what immediately preceded it).

The treatment of causes may stop the occurrence of seizures. This may include medical treatment of seizure disorders like epilepsy, surgical repair of tumors or brain lesions, and other treatments as needed.

Oral anticonvulsants (anti-seizure medications taken by mouth) are used to prevent or reduce the number of future seizures. Response is individual, and the medication and the dosage may have to be adjusted repeatedly.

Multiple, repeated seizures are usually treated with long-term use of an antiepileptic drug.

Follow-up includes reviewing the need for drugs at least yearly. Drugs may be required indefinitely. Monitoring the level of medicine in the blood is important to continue control of seizures, and to reduce side effects.

Pregnancy, lack of sleep, skipping doses of medications, use of recreational drugs (including alcohol), or illness may cause seizures in a person with a previously well-controlled seizure disorder.

Use of informational jewelry or cards (such as Medic-Alert or similar) that indicate a seizure disorder may be advised. These accessories may help in obtaining quick medical treatment if a seizure happens.

Outlook (Prognosis)

Seizures can occur as a single event or be recurrent. Seizures that recur with no identified causes are most commonly a chronic, lifelong condition termed epilepsy.

Seizures that occur once or in a single cluster are commonly caused by an acute condition, such as brain injury. They may occur secondary to an isolated incident, but can then develop into a chronic seizure disorder. Seizures within the first 2 weeks of a brain injury do not necessarily mean that a chronic seizure disorder will develop.

Serious injury can occur if seizure happen while driving, or when operating dangerous equipment. Each state has different policies on driving restrictions. Swimming and bathing without supervision are also not recommended. Contact sports are not advisable. These activities may be restricted for persons with poorly controlled seizure disorders.

Possible Complications

When to Contact a Medical Professional

Go to the emergency room or call 911 if:

Prevention

Treatment of any lesions or disorders may reduce the seizures. In many cases, epilepsy is caused by a genetic disorder and may not be preventable.