By: Aliana Gordon
What is Temporal Lobe Epilepsy?
Temporal lobe epilepsy affects one of the two temporal lobes that lie behind the temples, which is responsible for language, emotion, and short-term memory. Temporal lobe epilepsy (TLE) involves focal seizures, which are abnormal electrical discharges restricted to a region of the brain but may spread. Focal seizures also referred to as partial seizures, can be classified as simple or complex. Simple focal seizures are also referred to as auras when there is no loss of consciousness. Complex focal seizures are often related to TLE in which an individual may cease their current activity and stare into the distance. Long-term effects on the lobe may include shrinkage resulting in memory problems. The cause of the neurological disorder is typically unknown but can be a result of a brain injury, stroke, tumor, and scarring of the hippocampus.
Two types of focal seizures could occur, focal aware seizures or focal impaired awareness seizures. Focal aware seizures are when there is no change of consciousness during the seizure, formerly known as simple partial seizures without loss of awareness. The occurrence of this seizure could last from a few seconds to 2 minutes experiencing abnormal sensations, déjà vu, a sudden change in emotion, altered senses, and visual distortion. Focal impaired awareness seizures affect the level of consciousness to some degree lasting from 30 seconds to 2 minutes, formerly known as complex partial seizures with loss of awareness. The seizure can start in a localized area but often spreads. It is common for those to have an aura before a seizure resulting in staring, automatisms, confusion, unusual speech, and loss of the ability to communicate. A person cannot interact with the surrounding environment as they typically would.
The two temporal lobes exist on either side of the head, near the ears, and are responsible for processing auditory information. In the dominant hemisphere of the brain, opposite to the dominant hand, the most active areas of the Broca’s Area can be found.
The Broca’s Area is responsible for assisting in producing speech and understanding language while being networked throughout the brain. The temporal lobe is responsible for a great array of actions such as:
- processing emotions
- understanding language
- producing speech
- visual perception
- automatic bodily responses (i.e., appetite, emotions)
Symptoms of Temporal Lobe Epilepsy
An indication of an oncoming focal seizure is unusual sensations called auras. Auras can instigate strong emotions, changes in vision, déjà vu, and auditory hallucinations. However, memories of these experiences often vary between patients. A common sensation is a rising feeling in the abdomen similar to the effects of riding a roller coaster. The reaction of a focal seizure may result in impaired responsiveness which can be indicated by staring into space and a lack of response. Motor effects may be impacted by displaying repetitive actions such as lip-smacking and unusual motions in the fingers. The seizure may last a few seconds to 2 minutes. Following the seizure, patients often experience difficulty communicating, inability to recall the seizure, and extreme fatigue.
Are there treatments?
Treatment is carefully determined after a diagnosis from one of the following methods: electroencephalogram (EEG), computed tomography (CT or CAT) scan, Magnetic resonance imaging (MRI), or positron emission tomography (PET) scan. Medications are available to aid in treatment, although negative side effects can occur. Medication alone is perhaps ineffective, but a greater result can come from other therapies depending on various characteristics such as a vagus nerve stimulator (VNS) and the ketogenic diet. Additionally, responsive neurostimulation (RNS) has proven to be beneficial as it monitors the brain activity and will give stimulating pulses in response to abnormal activity. Surgery to remove the area responsible for the seizures is viable as long as no vital functions are being harmed.
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