Temporal Lobe Seizure - Symptoms, Diagnosis & Treatment

Temporal lobe seizure is a chronic neurological condition, caused by abnormal electrical activity in the temporal lobe of the brain. Learn about temporal lobe seizure causes, symptoms, diagnosis, treatment and prevention.

Temporal lobe is one of the sections of brain which is situated on either side of the brain just above the ear. Temporal lobe is the part of the brain that processes emotions, fight or flight reactions, and short-term memory. People who suffer from temporal lobe seizures may experience odd feelings ranging from euphoria to fear, deja vu, and hallucinations of taste or smell, at the onset of their seizures. Brief loss of consciousness is the main symptom of the Temporal lobe epilepsy. Loss of memory may be take place for the whole event. The person may appear drowsy, violent or intoxicated during the seizure.

A temporal lobe seizure acts as a warning. An unusual sensation or emotion, known as an aura may proceed in some people who have temporal lobe seizures experiences auras. Actually, the aura is a small seizure itself that has not spread into an observable seizure and impairs consciousness and ability to respond. A seizure beginning in the temporal lobes involves a temporary movement disturbance and may stem from an anatomical defect or scar.

Causes of Temporal Lobe Seizure:

When the abnormal electrical activity occurs in the temporal lobe, it produces a temporal lobe seizure. The brain’s function is altered by this activity and the person suffering the seizure will generally experience motor, sensory, or psychic symptoms or a change in the level of consciousness. Temporal lobe seizures may affect patient of any age, and can take place as a single episode or can be repeated as part of a chronic (ongoing) condition.

In communication with each other, brain cells produce consciousness, thoughts, and actions by various electrochemical processes. This normal function of the brain is interrupted by certain patterns of electrical activity and spread in abnormal patterns within the brain. On a brainwave test, electroencephalograph (EEG), you can see this process.

Anyone can have a seizure under the right conditions, for example exposure to certain drugs, high fever, or electrical stimulation. Particularly, seizures may take place in the temporal lobe of the brain. Commonly, they may be resulted due to damage to specific areas in that part of the brain with a head injury, infection, or damage to a portion of the temporal lobe due to lack of oxygen, brain tumors, genetic syndromes, or lesions of any sort. Brain-tissue scarring called mesial temporal sclerosis may also be produced due to many of these problems.

Seizures in the temporal lobe may start with feelings of fear, feelings of joy, recall of certain music, smells, and other unusual symptoms because this area is involved in consolidating memories and processing emotions.

Symptoms of Temporal Lobe Seizure:

Aura is the early warning symptom of a seizure, caused by the beginning of the seizure in a small part of the temporal lobe. The aura may stop on its own, or go on to spread, creating altered awareness. A “simple partial seizure”, aura can include:

• Sensation of deja vu, recalled emotions or memories
• Hallucinations or illusions (vision, smells, tastes, or other sensory illusions)
• A rising sensation in the abdomen (Epigastric sensations)
• Sudden, intense emotion not related to anything occurring at the time (similar to a panic attack)
• A sudden sense of unprovoked fear

The seizure is called “complex partial” if the electrical activity spreads and consciousness is altered or memory is lost. The following may take place during the complex partial seizure.

Abnormal sensations, including:

• Sensory hallucinations (visual, hearing, touch, etc.)
• Numbness, tingling, crawling sensation
• Preceding motor symptoms
• Occurring in only one part of the body or spreading

Autonomic (automatic) Nervous System symptoms may include:

• Dilated pupils (eyes)
• Abdominal pain or discomfort
• Nausea
• Sweating
• Flushed face
• Rapid heart rate/pulse

Changes in movement, including:

• Lip smacking
• Profuse salivation (“slobbering”)
• Abnormal mouth behaviors
• Chewing or swallowing without cause

Abnormal head movements, including:

• Forced turning of the eyes
• Usually in the direction opposite of the location of the brain lesion
• Forced turning of the head
• Consciousness is reduced or lost during the seizure
• Repetitive movements, such as picking at clothing
• Consciousness may be maintained, but memory lost (partly or completely)
• Rhythmic muscle contraction and relaxation (rare) — affecting one side of the body, one arm, leg, part of face, or other isolated area

Other symptoms can include:

• Loss of memory (amnesia) regarding events around the seizure (partial complex seizure)
• Changes in vision, speech, thought, awareness, personality

If you are suffering from temporal lobe seizures, your doctor will want to examine you and perform some diagnostic tests. Diagnosis of temporal lobe seizures may be suspected based on the person’s symptoms and the results of tests. It may include a complete physical examination, including a detailed neuromuscular examination, which may or may not be normal. Diagnosis will help to determine what treatment and medication should be prescribed to prevent seizures. Following are the example of some diagnostic tests:

• A head CT scan (computed tomography) or a cranial MRI (Magnetic resonance imaging) may show the location and extent of the lesion (a lesion is any scar, tumor, abnormal blood vessel, etc.).
• An EEG (electroencephalograph, recording of the brain’s electrical activity) evaluates the brain’s electrical activity and can also help locate abscesses and tumors. Also, it shows characteristic changes confirming partial (focal) seizures, and may show the focus (the brain area where the seizures start).
• Cerebral angiography can show the blood circulation in your brain and can detect any displacement of cerebral circulation or any hemorrhaging in the brain.
• Analysis of Cerebrospinal fluid can help to detect multiple sclerosis, tumors, infection, or an obstruction around the subarachnoid space of the spinal cord.
• A lumbar puncture (spinal tap) may be necessary.

Treatments:

The main goal of the seizures is to reduce the rate of future seizures and to perform emergency measures, if necessary. Some children outgrow temporal lobe, however this is less probable if brain scans show a defect or scar where the seizures are originating.  The seizures may made by the defect or scar makes and these are more difficult to control with medications.

Seek medical advice in these circumstances:

• When new signs or symptoms of seizures appear
• When the number of seizures experienced increases significantly without explanation
• Seek emergency medical care if a seizure lasts more than 5 minutes

If rhythmic muscle contractions or jerky movements take place in someone having a temporal lobe seizure, a grand mal seizure may be developing. Follow these tips:

• Loosen tight neckwear.
• Call for medical help immediately.
• Gently roll the person onto one side and put something soft under his or her head.
• Don’t try to restrain the person. Look for a medical alert bracelet, which may indicate an emergency contact person and other information.
• Don’t put anything in the mouth, the tongue can’t be swallowed and objects placed in the mouth can be bitten or inhaled.

Medication:

Temporal lobe seizures can be completely or at least mostly controlled with the medications. During taking anti-seizure medication, it is more important to follow doctor’s instructions exactly. Many seizure medicines can be used, either alone or in combination. If you take too much or too little of the drug, it can cause seizures. You can’t take any over-the-counter medication without doctor’s prescription.

Numerous medications are available to treat seizures, including:

• Carbamazepine (Tegretol)
• Phenobarbital
• Zonisamide (Zonegran)
• Phenytoin (Dilantin)
• Lamotrigine (Lamictal)
• Levetiracetam (Keppra)
• Valproic acid (Depakene)
• Oxcarbazepine (Trileptal)
• Tiagabine (Gabitril)
• Pregabalin (Lyrica)
• Felbamate (Felbatol)
• Gabapentin (Neurontin)
• Topiramate (Topamax)

The dosage of your medicine will be altered periodically by doctor if your blood levels have changed.  Medication can’t cure the underlying cause. However, it can help to prevent seizures. Many people don’t attain seizure control with medications alone. Fatigue and dizziness are the possible side effects of anti-seizure medications.

Surgery:

If drug therapy fails to work, surgery becomes necessary. Surgery can correct or lessen the severity of the seizure disorder. Surgery to eliminate the portion of the temporal lobe that’s causing the seizures is often effective. Depending on the cause of the temporal lobe seizures, success rates of surgery range between about 65 percent to as high as 90 percent. If seizures originate from a part of the brain that contains vital brain functions, and in cases where the seizures come from more than one area, surgery is rarely an option.

A temporal lobectomy, an operation usually removes only the abnormal part of the temporal lobe. In about 70% patients, temporal lobectomy is successful, with low complication rates. Side effects of temporal lobectomy are loss of memory, and emotional change, visual disturbances related with the removal of brain tissue. Some side effects that take place after the surgery and go away on their own include scalp numbness, nausea, difficulty speaking, feeling tired or depressed, headaches, remembering or finding words and continued auras (feelings that signal the start of a seizure).

Lifestyle and home remedies:

You may require taking special precautions to keep yourself and those around you safe if your temporal lobe seizures aren’t well controlled. These precautions may incorporate limiting activities such as swimming, driving, working at heights and operating heavy equipment and altering some routines, for example taking showers instead of baths. To help emergency medical personnel, you might also consider wearing a medical bracelet.

Possible Complications:

• Injury from falls, bumps, biting self, etc.
• Injury from a seizure occurring during driving or operating machinery
• Breathing fluid, such as saliva, during a seizure can cause pneumonia
• Repeated seizures (epilepsy)
• Permanent brain damage (stroke or other damage)
• Progression to generalized (grand mal) seizures
• Side effects of medications (with or without visible symptoms)
• Prolonged seizures, seizures that happen close together (status epilepticus)

Prevention:

A seizure can be caused by caffeine and alcohol. They can also fatigue and illness. If you suffer from seizures, most of these things can be avoided as they trigger seizures. Seizures can also be triggered by some sights and sounds such as flashing video, television, or computer screens, and construction noises. Treatment of any lesions or disorders may reduce the seizures but in many cases, seizures can be caused by a genetic disorder and may not be preventable.