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Temporal Lobe Epilepsy: TLE

A temporal lobe seisure starts in the part of the brain that processes emotions, fight or flight reactions, and short-term memory. Many who have temporal lobe seisures may experience odd feelings ranging from euphoria to fear, deja vu, and hallucinations of taste or smell at the onset of their seisures.

Seisures beginning in the temporal lobes may stem from an anatomical defect or scar. But, it's not always possible to determine the cause of a temporal lobe seisure.

Temporal lobe seisures are often resistant to anti-seisure medications. Surgery may be an option for some people if their seisures consistently begin in only one of their two temporal lobes. Many become free of temporal lobe seisures when the affected portion of the lobe is removed.

An unusual sensation or emotion, known as an aura, may precede a temporal lobe seisure, acting as a warning. Not everyone who has temporal lobe seisures experiences auras, and those who do have auras may not remember them. The aura is actually a small seisure itself one that has not spread into an observable seizure that impairs consciousness and ability to respond. Examples of auras include:

■ A sudden sense of unprovoked fear
■ A deja vu experience
■ The sudden occurrence of a strange odor or taste
■ A rising sensation in the abdomen

People who have temporal lobe seisures usually remain partially conscious during a seisure, but they lose awareness of their surroundings and usually don't remember what happened.

A temporal lobe seisure usually lasts 30 seconds to two minutes. Characteristic signs and symptoms of temporal lobe seisures include:

■ Loss of awareness of surroundings
■ Staring
■ Lip smacking
■ Repeated swallowing or chewing
■ Unusual finger movements, such as picking motions

After a temporal lobe seisure, you may have:

■ A brief period of confusion and difficulty speaking
■ Inability to recall the events that occurred during the seisure
■ Unawareness of having had a seisure until someone else tells you

In extreme cases, what starts as a temporal lobe seisure evolves into a grand mal (tonic-clonic) seisure featuring convulsions and a loss of consciousness. About half of people with temporal lobe seisures never experience a grand mal seisure.

During normal waking and sleeping, your brain cells produce varying electrical activity. If the electrical activity in many brain cells becomes abnormally synchronised, a convulsion or seisure may occur. If this happens in just one area of the brain, the result is a focal or partial seisure. When this occurs in an area of the brain known as the temporal lobe, it's called a temporal lobe seisure.

Temporal lobe seisures can be a result of:

■ Traumatic injury
■ Infections, such as encephalitis or meningitis, or history of such infection
■ A process that causes scarring (gliosis) in a part of the temporal lobe called the hippocampus
■ Injury due to a previous lack of oxygen
■ Blood vessel malformations in the brain
■ Stroke
■ Brain tumors
■ Genetic syndromes

Over time, repeated temporal lobe seisures can cause the part of the brain that's responsible for learning and memory to shrink. This area is called the hippocampus. Brain cell loss in this area may cause memory problems.

People who experience Temporal Lobe Seisures can believe that they are experiencing paranormal disturbances. It is very easy for them to believe that their unusual feelings and hallucinations are somehow attributed to the paranormal or supernatural. Some may even believe that they are psychic in some way due to the seeing of auras.

Compiled by the Mayo Clinic & Steve Mera.