Temporal Lobe Seizures: Causes, Symptoms, Diagnosis, Treatment and Complications

Temporal lobe seizures originate in the temporal lobes of the brain. These areas are critical for processing emotions and short-term memories. Certain tasks may be linked to temporal lobe seizures. Some people have odd feelings of exhilaration, deja vu, or anxiety during a seizure.

Another term for temporal lobe seizures is focal seizures with diminished consciousness. A small percentage of people remain cognizant during the seizure. If the seizure is more severe, the person may still look aware but not react to their environment. The person may move their mouth and hands repeatedly.

The cause of temporal lobe seizures is typically not known. On the other hand, a temporal lobe scar might be the reason. The temporal lobe is the source of seizures that are treated with drugs.

Causes Of Temporal Lobe Seizures

The reason for a temporal lobe seizure is often unknown. But they could originate from several places, like:

• Brain injury.
• Infections such as meningitis or encephalitis, or a history of these diseases; an operation that injures the temporal lobe's hippocampus region. This is known as gliosis.
• Anomalies of the brain's blood vessels.
• Strokes, brain tumors, and genetically based disorders.

Your brain cells produce different electrical activity while you are asleep and awake. A large number of brain cells experiencing an increase in electrical activity may cause a seizure. This results in a focal seizure, which happens in just one area of the brain. A temporal lobe seizure is a type of focused seizure that originates in one of the temporal lobes.

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Symptoms Of Temporal lobe seizures 

An aura is an abnormal sensation that might occur before a temporal lobe seizure. Auras act as warning signs. Not all cases of seizures involving the temporal lobes exhibit auras. Moreover, not every aura holder can remember their auras.

During a focused seizure, there is an aura before the sufferer passes out. Examples of auras are as follows:

• A sudden sensation of happiness or fear.
• The sensation of deja vu is the perception of a past event.
• An odd or surprising flavor or aroma.
• A feeling of ascent in the abdomen is similar to being on a roller coaster.
• Periodically, temporal lobe seizures may impair your ability to interact socially. The typical duration of this type of temporal lobe seizure is thirty to sixty seconds.

A temporal lobe seizure manifests as the following symptoms:

• Being unaware of people and things around you.
• Gazing.
• Licking your lips.
• Regular swallowing or chewing.
• Finger movements, like plucking.

After a temporal lobe seizure, you may experience:

• A period of confusion and trouble speaking.
• Losing track of what transpired during the seizure.
• Not recognizing that they had suffered a seizure.
• Deep sleep.
• In extreme cases, temporal lobe seizures can progress to generalized tonic-clonic seizures. During a seizure, the shaking is called convulsions, and it leaves a person unconscious. It is sometimes referred to as a grand mal seizure.

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Diagnosis Of Temporal lobe seizures

After a seizure, your doctor often looks over your symptoms and medical background. Your doctor may recommend several tests to determine the cause of your seizures. This helps assess the likelihood that you may have another seizure.

Tests might include:

• Evaluation of the nervous system: Your doctor may examine your behavior, mental acuity, and motor abilities. This can give your doctor information on the condition of your brain and nervous system.
• Blood tests: Your medical professional may take a blood sample. Test findings can be used to search for signs of high blood sugar, electrolyte imbalances, genetic problems, or infections.
• The electroencephalogram, or EEG: Electrodes, which are flat metal discs attached to your head, record the electrical activity of your brain. This will result in wavy lines appearing in an EEG recording. By analyzing the EEG, medical practitioners can identify patterns that indicate the likelihood of a seizure returning. An EEG can also help rule out other conditions that mimic epilepsy.
• Computerized tomography, or CT scan: Using X-rays, a CT scan produces cross-sectional images of your brain. A CT scan can reveal possible causes of seizures. The scans can reveal tumors, bleeding, and cysts.
• Magnetic resonance imaging is referred to as MRI: In an MRI, radio waves and powerful magnets are utilized to create a comprehensive picture of your brain. Your physician may be able to determine what may be causing your seizures.
• Positron Emission Tomography is known as PET: PET scans use a very small amount of low-dose radioactive material. The material is injected into a vein. This facilitates the imaging of areas of the brain active. PET imaging can be used to identify the areas of the brain where the seizure originated.
• Computerized single-photon emission tomography (SPECT): SPECT testing uses a very small amount of low-dose radioactive tracer. To create a detailed, three-dimensional representation of the blood flow throughout the brain during a seizure, the tracer is administered intravenously. Subtraction ictal SPECT connected to magnetic resonance imaging (SISCOM) is a form of SPECT test that can yield even more accurate results.

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Treatment Of Temporal lobe seizures

Not every seizure is followed by another. Seizures can happen on their own. Your doctor will likely put off starting treatment until after you've gone through a lot.

The ultimate goal in treating seizures is to find the medication that will stop the seizures the quickest while causing the fewest side effects.

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Medications

There are several different ways to treat temporal lobe seizures. However, a lot of individuals discover that taking medicine alone is not enough to stop their seizures. Adverse reactions are also common. These might include fatigue, dizziness, and weight gain.

Discuss any possible side effects with your healthcare provider as you consider your treatment options. Find out if there are any possible drug interactions between the prescriptions you take for seizures and other medications. 

For instance, several anti-seizure drugs may lessen the efficiency of oral contraceptives. Alternative therapy may be taken into consideration if anti-seizure medicines prove to be ineffective.

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Surgery and other procedures

Surgery is performed to prevent seizures. Standard surgery is often used to achieve this, during which the seizure-causing brain region is removed by the surgeon. With less invasive techniques like MRI-guided laser therapy, surgeons might be able to remove the damaged tissue that is triggering seizures in certain individuals.

Surgery is the best course of action for people whose seizures always begin in the same part of the brain. Surgery is typically not an option if multiple brain regions are involved in your seizures. Surgery may also not be an option if the cause of your seizure cannot be identified. This may also be the case if your seizures are coming from a part of your brain that is involved in important functions.

Following are mentioned few of the surgical treatment options:

• Stimulation of vagus nerve stimulation: A device is implanted under the skin on your chest to stimulate the vagus nerve in your neck. This sends signals to your brain that stop seizures. In addition to vagus nerve stimulation, you may still need medicines. But you may be able to cut the dosage.
• Responsive neurostimulation: epileptic activity during responsive neurostimulation can be detected by a device inserted into the brain or applied to its surface. Afterward, the device stimulates the region electrically to end the seizure.
• Deep mental stimulation: This therapy is administered by a surgeon using electrodes inserted into specific brain areas. To prevent seizures, the electrodes emit electrical impulses that regulate brain activity. A device that looks like a pacemaker is attached to the electrodes beneath the skin of your chest. With this device, you may control the amount of stimulation produced.
• Dietary intervention: Managing seizures may be aided by a ketogenic diet. The diet is high in fat and low in carbohydrates. The diet might be difficult to follow because of its restrictions. Keto diet modifications are less effective, yet they might still be helpful in some situations. These include low-glycemic index diets and modified Atkins diets.

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Pregnancy and seizures

Seizable mothers can usually give birth to healthy kids while they are pregnant. It is important to remember, nevertheless, that certain drugs have the potential to cause birth defects.

Particularly, valproic acid has been connected to neural tube defects such spina bifida and cognitive deficits. Valproic acid is one possible drug for generalized seizures. 

Discuss these risks with your doctor. 

Pregnancy not only raises the risk of birth defects but also modifies medication levels. If you have ever had seizures before becoming pregnant, you must talk to a healthcare expert about your medication schedule.

If you take any medicine for seizures before or during pregnancy, you should periodically change the dosage. Changing prescriptions is another option when expecting.

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Prescription drugs for seizures and birth control

It's also important to realize that some anti-seizure drugs can make oral contraceptives a form of pregnancy control less effective. Moreover, certain oral contraceptives speed up the medication's absorption that is used to cure seizures. Consult your healthcare provider to determine whether your prescription and oral contraception interact. 

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Complications Of Temporal Lobe Seizures

The part of the brain responsible for memory and learning may eventually shrink as a result of recurrent temporal lobe seizures. This area of the brain is known as the hippocampus. Loss of hippocampus brain cells may cause memory problems.

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