What is epilepsy?

Epilepsy is a condition that causes repeated seizures. Seizures are episodes of disturbed brain activity where you temporarily lose control of your body and your mind.

Epilepsy is not a single condition but a group of syndromes. People with epilepsy have abnormal activity in the brain. This activity can change and cause seizures. The type of seizure depends on where the abnormal activity occurs in the brain. There are many different types of seizures and they affect people differently.

A seizure occurs when there’s a sudden burst of electrical activity in the brain. This can cause unusual sensations, emotions and behaviors, or loss of consciousness.

The brain has billions of nerve cells (neurons) that communicate with one another through electrical and chemical signals. Neurons send signals to other neurons through branches called axons. When these electrical signals get disrupted, it can cause a seizure.

What is temporal lobe epilepsy?

Temporal lobe epilepsy is a type of epilepsy that affects the temporal lobes of the brain, which are located in the sides and upper middle portion of the head. The temporal lobes play an important role in memory and emotions.

Types of temporal lobe epilepsy include:

Simple partial seizures. These seizures begin in one side of the brain and affect only part of it. The person may stare blankly or experience involuntary movements on one side of their body. Simple partial seizures rarely cause loss of consciousness or convulsions.

Complex partial seizures (formerly called psychomotor seizures). Complex partial seizures can take many forms, but they all involve both sides of the brain at once, causing loss of consciousness, convulsions or both. Complex partial seizures may be preceded by auras like déjà vu or jamais vu (a feeling that something has happened before although it hasn’t). They are also sometimes associated with hallucinations — seeing things that aren’t really there — or visions that appear as real but aren’t related to reality (such as believing someone is standing behind you when they’re actually sitting across from you). Some people remember what happened during these events while others don’t recall anything after they happen.

What causes temporal lobe epilepsy?

The cause of temporal lobe epilepsy is unknown. However, it has been linked to a number of factors that are thought to make a person more vulnerable to developing this condition. These include:

Head trauma. A blow or jolt to the head can trigger seizures in people with temporal lobe epilepsy. This may be due to any damage caused by the injury, but it may also be that the brain changes associated with a seizure alter the way it responds to incoming signals.

Genetics. Temporal lobe epilepsy often runs in families, suggesting that it’s inherited. However, many people with the condition have no family history of it, suggesting that there are other factors at play in its development.

Gender and age. Women are three times more likely than men to develop temporal lobe epilepsy, and it usually develops between ages 20 and 50 — although children and older adults can also be affected by this condition.

What are the symptoms of temporal lobe epilepsy?

The most common symptom is a seizure, which can be mild or severe. A seizure is caused by a sudden burst of electrical activity in the brain. Seizures can cause you to lose consciousness and fall down (drop). You may have strange sensations such as numbness, tingling, or odd smells. You might also lose control of your muscles for a short time and do things you’re not aware of doing. The symptoms of a seizure can vary from one person to another.

Some people with TLE have frequent seizures that happen over and over again during their lifetime. Others have only one or two seizures in their lifetime. Some people who have TLE don’t experience any symptoms at all.

Seizures are more common in young adults than older adults because the brain is still growing during this time period and more prone to developing new connections between nerve cells that can cause seizures.

Who is at risk for temporal lobe epilepsy?

The risk of developing temporal lobe epilepsy is increased if you have a family history of the disorder.

Temporal lobe epilepsy can also be associated with other conditions, including:

• Birth trauma
• Brain injury
• Brain tumor (malignant)
• Drug use (illicit)

How is temporal lobe epilepsy diagnosed?

The diagnosis of temporal lobe epilepsy usually involves an EEG and MRI scan. The EEG measures the electrical activity in your brain, while the MRI scan helps doctors to identify any abnormalities in your brain structure.

If you have a seizure that isn’t caused by another medical condition, such as alcohol withdrawal or drug abuse, it’s likely to be diagnosed as temporal lobe epilepsy.

If you have had a seizure but don’t have any other symptoms of temporal lobe epilepsy, you may be referred to a specialist epilepsy clinic for further tests. These will typically include an EEG and MRI scan, but sometimes further tests are needed if the diagnosis hasn’t been confirmed. For example:

A sleep study (polysomnogram) may help detect if there are any unusual electrical patterns occurring during sleep that could be contributing to seizures

An MRI scan with 3D reconstruction (magnetic resonance imaging) can show if there are any structural abnormalities within your temporal lobes that may be causing seizures.

How is temporal lobe epilepsy treated?

There are multiple types of medications that can be used to treat temporal lobe epilepsy, including:

Anti-seizure drugs. These medications reduce the risk of seizures by increasing the effectiveness of brain cells (neurons) in keeping electrical activity under control. Examples include carbamazepine (Tegretol), lamotrigine (Lamictal), oxcarbazepine (Trileptal) and valproic acid (Depakote).

Antiepileptic drugs. These drugs have been approved by the Food and Drug Administration for treating partial onset seizures in adults. They act on neurotransmitters — chemical messengers in the brain — to reduce excitability of neurons and prevent them from generating abnormal activity that leads to seizures. Examples include levetiracetam (Keppra) and topiramate (Topamax).