Somatosensory auras in refractory temporal lobe epilepsy. Temporal lobe epilepsy an overview sciencedirect topics. Temporal lobe or psychomotor seizures are caused by abnormal electrical activity in one area of the brain. Temporal lobe epilepsy is the most common epilepsy of adulthood, and despite a considerable genetic impact, few genetic alterations are known.
Temporal lobe epilepsy tle is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. Adpeaf is a familial temporal lobe epilepsy syndrome that is characterized by auditory features as described in the case vignette. It can be hard for people with tle to become completely seizure free with seizure medicines alone, though medicines may lower the number of seizures. Jun 18, 2019 temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for shortterm memory. Little is known about the epidemiology of tle, because it requires advanced neuroimaging, positive eeg, and appropriate clinical semiology to confirm the. The bible may contain the oldest recorded case of temporal lobe epilepsy. Results clinical characteristics table 1 presents clinical summaries of the patients. Evidence will be presented to demonstrate that the cognitive consequences of this focal seizure disorder can be more generalized in nature than expected. To analyse the long term results of temporal lobe epilepsy surgery in a national epilepsy surgery centre for adults, and to evaluate preoperative factors predicting a good postoperative outcome on long term follow up. Some symptoms of a temporal lobe seizure may be related to these functions, including having odd feelings such as euphoria, deja vu or fear. In this case, we see the consequences of the excessive emotional representation arising from the epilepsy. While temporal lobe epilepsy tle is the most common form of epilepsy in adults, seizure fo ci in children are more often extratemporal in. It is postulated that both were manifestations of temporal lobe epilepsy.
Update on temporal lobe epilepsy a special issue journal published by hindawi temporal lobe epilepsy tle is the most common form of focal epilepsy that may secondarily generalize. From rostral to caudal, they are the, the, and the. A history of febrile seizures especially complex febrile seizures is common in tle and is frequently associated with mesial temporal. Medial temporal lobe the limbic system on the medial surface of the temporal lobe are three structures critical for normal human functioning. Patients often complain of poor memory for recent events, and this may get worse as the epilepsy continues. It has unique symptoms and is also associated with personality changes. No tumour or gross vascular malformation had been recognized. The symptoms associated with temporal lobe epilepsy vary depending on the underlying cause and the precise location of the abnormal electrical activity. Temporal lobe epilepsy list of high impact articles ppts. Secondary generalisation is much less common than in extra temporal lobe epilepsy. Eeg in the diagnosis, classification, and management of.
Temporal lobe epilepsy tle is the most common type of partial epilepsy, with often characteristic imaging and clinical findings. It is a chronic disorder and clinically resembles chronic schizophrenia symptoms of delusions, hallucinations, thought disorder but there are some reports that personality is. Objective to assess whether hippocampal sclerosis hs severity is mirrored at the level of largescale networks. In fact, 90% of patients with temporal interictal epileptiform abnormalities on their electroencephalograms eegs have a history of seizures. Temporal lobe epilepsy represents the largest group of patients with treatment resistantmedically intractable epilepsy undergoing epilepsy. We could not find any indication that socrates had a secondarily generalized seizure, nor could we find evidence of chronic progressive cognitive decline. Focal epilepsies include idiopathic locationrelated epilepsies ilre, frontal lobe epilepsy, temporal lobe epilepsy, parietal lobe epilepsy and occipital lobe epilepsy. The temporal lobe is located at the bottom of the brain below the lateral fissure.
Neuropsychological deficits in temporal lobe epilepsy. This area of the brain is involved in controlling emotions and shortterm memory. Presurgical thalamic hubness predicts surgical outcome. Approximately 50% of patients with epilepsy have partial epilepsy. Temporal lobe epilepsy definition of temporal lobe epilepsy.
It has been attempted to link seizure semiology to activation of different anatomical regions of the. The most common form of partial epilepsy, temporal lobe epilepsy remains a mystery regarding cause and effective seizure treatment methods. Interictal psychosis is the most common and may resemble schizophrenia. The diagnosis may instead be made through observation of symptoms or the use of brain imaging technology. Electroencephalography eeg has an important role in the diagnosis and classification of epilepsy. A quantitative mri index for assessing the severity of. The psychoses of epilepsy can be classified according to their temporal relationship with seizures, namely as ictal, postictal and interictal psychosis. Temporal lobe seizures are usually stereotypic in their symptoms. Loss of awareness occurs during a focal dyscognitive seizure when the seizure spreads to involve both temporal lobes.
Psychiatric disorders in epilepsy epilepsy society. Therapeutic approaches may involve the use of natural progesterone or changes of the doses of current antiepileptics. Temporal lobe, or psychomotor, seizures are caused by abnormal electrical activity in an area of the brain known as the temporal lobe, which sits just above your. Preoperatively all patients were socially incapacitated. The term temporal lobe epilepsy tle was included in the classification of the ilae in. It is a chronic neurological condition characterized by recurrent, unprovoked epileptic seizures epilepsy which originate in the temporal lobe of the brain. Electroencephalography in mesial temporal lobe epilepsy.
A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. This survey covers 74 patients with temporal lobe epilepsy, resistant to medication, who underwent unilateral temporal lobectomy during the years 19601969 at rigshospitalet, copenhagen. Studies have shown that recurrent seizures affect all aspects of cognitive functioning, including memory, language, praxis, executive functions, and social judgment, among several others. Mesial temporal sclerosis and temporal lobe epilepsy. Temporal lobe epilepsy also known as tle is is characterized by abnormal electrical activity in the temporal lobe region of the brain.
Your source for comprehensive information on epilepsy from a community around the globe. Full text get a printable copy pdf file of the complete article 1011k, or click on a page image below to browse page by page. Jan 27, 2016 this scientific commentary refers to temporal plus epilepsy is a major determinant of temporal lobe surgery failures, by barba et al. Dec 22, 2017 temporal lobectomy is the definitive treatment for medically intractable temporal lobe epilepsy, as it has a high seizurefree rate. It is a type of focal epilepsy, and is characterized by recurrent seizures. Complex partial seizures, as in psychomotor temporal lobe epilepsy, usually, but not always, originate in the temporal lobe of the brain, often with a preceding aura. The table summarizes our findings and interpretation. Women with focal seizures, especially temporal lobe epilepsy are more prone to have seizures during the period of menstruation. The international league against epilepsy ilae defines epilepsy as a condition characterized by two or more recurrent epileptic seizures over a period longer than 24 hours, unprovoked by any immediate identified cause 4, 5. About onethird of patients with tle may become resistant to medical therapy and require surgical treatment. This study aims to determine whether there are important clinicoelectrical differences between patients with temporal lobe epilepsy tle secondary. A specific anatomoelectroclinical phenotype in the temporal lobe epilepsy spectrum author links open overlay panel giuseppe didato a valentina chiesa b flavio villani a veronica pelliccia c francesco deleo a francesca gozzo c maria paola canevini b d roberto mai c roberto spreafico a massimo cossu c laura tassi c. Real stories help epilepsy blog readers find new treatments, connect with others and take action to.
Kids with temporal lobe epilepsy tle have seizures that start in one of the temporal lobes of the brain. Jun 05, 2015 temporal lobe epilepsy tle may be simple focal seizures without loss of awareness with or without aura or focal dyscognitive seizures with loss of awareness. The diagnosis of temporallobe epilepsy was established clinically on the basis of the course of the seizure. Standardized definitions are crucial for epidemiological research. Temporal lobe epilepsy tle is the commonest form of focal epilepsy and represents almost 23 of cases of intractable epilepsy managed surgically. Epilepsy, temporal lobe definition of epilepsy, temporal. Mechanisms influence of sleep supported by specific seizure disorders have seizures only during sleep temporal lobe seizures are most common nocturnal seizures frontal lobe seizures have higher prevalence during sleep possible thalamocortical activation. We therefore suspect that socrates tle was mild, stable, and relatively benign. Temporal lobe epilepsy may be treated with the same antiseizure medications that are used for other forms of epilepsy. Temporal lobe seizure symptoms and causes mayo clinic. Temporal lobe seizures are characterized by behavioral arrest and impaired awareness.
This lobe is the location of the primary auditory cortex, which is important for interpreting the sounds and language we hear. The automatisms of mediobasal temporal lobe epilepsy are typically less violent than in frontal lobe seizures, and are usually oroalimentary lipsmacking, chewing, swallowing, or gestural e. As the name implies, there are many different cognitive, affective, and psychomotor symptoms. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies.
Hippocampal onset accounts for at least 80% of all temporal lobe seizures. Jan 19, 2010 a clip showing a patient with temporal lobe epilepsy. Temporal lobe epilepsy for parents nemours kidshealth. Ezekiel, the prophet whose visions are recorded in a book of the old testament, apparently had all the. Old testament prophet showed epileptic symptoms new scientist. In all patients a unilateral or predominantly unilateral temporal eeg focus was found. Diagnosis and treatment of temporal lobe epilepsy orrin devinsky, md departments of neurology, neurosurgery, and psychiatry, new york university school of medicine, new york, ny of the 1,200,000 americans with partial epilepsy, temporal lobe epilepsy tle occurs in more than 400,000. Aug 21, 2018 the temporal lobe functions as one of the four main regions of the brain found within the cerebral cortex, and it is responsible for things like speech, memory, and facial recognition. People with drugresistant medial temporal lobe epilepsy have a higher risk for memory and mood difficulties. Temporal lobe epilepsy tle is the commonest form of focal epilepsy and represents almost 23 of cases of intractable. Hippocampal sclerosis hs is the most common pathology identified on magnetic resonance imaging mri of patients treated with. Automatisms are common during the seizure, and include oral andor manual automatisms.
Temporal lobe epilepsy tle is the most common form of focal partial epilepsy. Pathologic findings in surgical resections from patients with temporal lobe epilepsy include a wide range of diagnostic possibilities that can be categorized into different groups on the basis of etiology. The features of temporal lobe epilepsy are extremely diverse. Most forms of epilepsy result in simple and complex partial seizures, meaning only one lobe is affected. Tle is the most common type of partial seizure, affecting 60% of people. In this process emotions are important for shortterm memory. Dec 22, 2017 the temporal lobe is the most epileptogenic region of the brain.
Temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for shortterm memory. They are involved in recognition and processing of sound, language and smells and play a key role in the formation of memory. The ilae strives to provide definitions for key concepts and classification schemes that will help the world epilepsy community in developing a common language to communicate effectively regarding the many facets of epilepsy. Temporal lobe epilepsy tle is the most prevalent form of complex partial seizures with temporal lobe origin of electrical abnormality. Surgical treatment of refractory temporal lobe epilepsy. For patients who had mesial temporal lobe epilepsy and disabling seizures for no more than 2 consecutive years following adequate trials of 2 brandname aeds, engel et al found that resective surgery plus aed treatment resulted in a lower probability of seizures. Parietal lobe epilepsy is a very rare type of epilepsy. Focal epilepsy may be treated with medication, and occasionally with diet, nerve stimulation or surgery, especially if the condition is due to a scar or other lesion in the brain. The most common cause of tle is hippocampal sclerosis hs, accounting for 80% of tle patients and 30. Hypersalivation in temporal lobe epilepsy 645 evaluation, and wada testing patient 2 did not have a wada test.
Temporal lobe epilepsy medical definition merriamwebster. Seizure triggers epilepsy centers of excellence home. Along with three other lobes the occipital lobe, the frontal lobe, and the parietal lobe it makes up the cerebrum. Research article open access a quantitative mri index for assessing the severity of hippocampal sclerosis in temporal lobe epilepsy wanchen dou1, lei zhao2, changbao su1, qiang lu3, qi liu1, jinzhu guo1, yuming zhao1, yishan luo2, lin shi2,4, yiwei zhang5, renzhi wang1 and feng feng5 abstract. They represent approximately two thirds of the intractable seizure. Focal seizures are the most common form of seizure in adults and one of the most common forms of seizures in children. Types, triggers and facts about epileptic seizures.
There may sensory auditory, emotional fear, cognitive deja vu or autonomic features epigastric sensation, tachycardia, colour change prior to onset of impaired. Long term outcome of temporal lobe epilepsy surgery. The temporal lobes are on the sides of the brain behind the temples. Temporal lobe epilepsy is the type of epilepsy that accounts for the most common form of seizures called focal seizures. About 6070% of focal seizures originate in the temporal lobe. Temporal lobe epilepsy is a type of epilepsy characterized by the. Effects of chronic temporal lobe epilepsy on memory functions. Temporal lobe seizures are the most frequent site of origin of partial seizures. Temporal lobe epilepsy tle is one of the most common causes of epilepsy in adults and can arise sporadically or with a clear familial recurrence 1. For many years it has been held that these lesions may be related to complicated febrile convulsions in childhood but the association is based on retrospective data and a. Partialonset epilepsies account for about 60% of all adult epilepsy cases, and temporal lobe epilepsy tle is the most common type of partial epilepsy referred for epilepsy surgery and often refractory to antiepileptic drugs aeds. The onset of temporallobe epilepsy extended back to the first decade of life in 21 patients and to the second decade in 16 of the patients. Dec 11, 2018 temporal lobe epilepsy is difficult to diagnose because temporal lobe seizures may not show up on an eeg. Neuropsychology and temporal lobe epilepsy cns spectrums.
Longitudinal follow up of 140 consecutive adult patients operated on for drug resistant temporal lobe epilepsy. Temporal lobe epilepsy caused by mesial temporal sclerosis and. In lateral temporal seizures, ictal onset eeg changes are usually lateralised, and more likely to have a repetitive epileptiform appearance than. Temporal lobe epilepsy tle is the most common form of adult localizationrelated epilepsy. Methods we studied preoperative highresolution anatomical and diffusionweighted mri of 44 temporal lobe epilepsy tle patients with histopathologic diagnosis of hs n 25. When is temporal lobe epilepsy not temporal lobe epilepsy. Symptoms of left temporal lobe epilepsy only epilepsy. I went through whats called a presurgical eeg and the results showed that my seizure focus is in my left temporal lobe right beside the speech area of my brain. Have left temporal lobe epilepsy myself, and number one common symptom i have is slurred speech. Understanding temporal lobe seizure the basics webmd. Temporal lobe epilepsy list of high impact articles.
Temporal lobe epilepsy is the most common cause of partial or focal seizures. They can be challenging to diagnose and to manage, especially given the perception that some antipsychotic drugs may exacerbate seizures, while some antiepileptic. Temporal plus epilepsies are characterized by seizures involving a complex epileptogenic network including the temporal lobe and the closed neighboured. Temporal lobe epilepsy tle represents the most prevalent form of localization. Ictal clinical and scalpeeg findings differentiating temporal lobe. Seizure outcomes after resective surgery for extratemporal lobe. In mesial temporal epilepsy, the typical ictal onset pattern is a rhythmic. This paper outlines the various pathologic entities described in temporal lobe epilepsy, including some newly recognized epilepsy associated tumors, and briefly touch on the recent.
In temporal lobe epilepsy tle seizures could originate in the medial or lateral neocortical temporal region, and many of these patients are refractory to medical. To determine the prevalence, manifestations, lateralizing value, and surgical prognostic value of somatosensory auras. The temporal relation between seizure onset and arousal. In this lesson, we will learn about the many unusual symptoms as well as the treatment for this type of epilepsy. The temporal lobe is a region of the cerebral cortex on both hemispheres of the brain located approximately at the level of the ears. Temporal lobe epilepsy tle describes the abnormal electrical activity that occurs within the temporal lobe of the brain. Temporal lobe epilepsy radiology reference article. Focal epilepsy is often of temporal lobe origin but the true. Temporal lobe epilepsy may be more likely to cause long term problems in memory this is based on the anatomy of the temporal lobe, including the hippocampus and amygdalaimportant in memory.
1121 1199 1541 1137 210 857 245 127 1033 765 1602 1504 826 740 547 567 1443 872 1519 506 761 270 1523 1380 459 1487 608 428 421 1187 1144 1287 1161 912 505 1374 1131 895 883 1388 461 33 621 1100 247 723 759