Temporal lobe seizure

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Central nervous system

TLE; Seizure - temporal lobe

The early warning symptoms (called an aura) include:

• Abnormal sensations
• Epigastric sensations ("a funny feeling in my gut," "stomach rising")
• Hallucinations or illusions (vision, smells, tastes, or other sensory illusions)
• Sensation of deja vu, recalled emotions or memories
• Sudden, intense emotion not related to anything occurring at the time

During the seizure:

• Consciousness maintained during the seizure (partial)
• Consciousness reduced or lost during the seizure (partial complex)

• Abnormal mouth behaviors
  • Lip smacking
  • Chewing or swallowing without cause
  • Profuse salivation "slobbering"
• Abnormal head movements
  • Forced turning of the head
  • Forced turning of the eyes
  • Usually in the direction opposite of the location of the brain lesion
• Repetitive movements, such as picking at clothing
• Rhythmic muscle contraction and relaxation (rare) -- affecting one side of the body, one arm, leg, part of face, or other isolated area

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

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

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

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.

• An EEG (electroencephalograph, recording of the brain's electrical activity) shows characteristic changes confirming partial (focal) seizures, and may show the focus (location of the cause).
• A head CT scan or a cranial MRI may show the location and extent of the lesion.
• A lumbar puncture may be necessary if there is suspicion of an infection causing the seizure.

Review Date: 09/07/2006
Reviewed By: Kenneth Gross, M.D., Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network.