Seizures happen when there’s a burst of electrical activity in many brain cells. They can be triggered by a variety of things, including certain medicines, injuries and infections such as meningitis or encephalitis. They can also be caused by genetic problems and birth defects.
Temporal lobe epilepsy is the most common type of seizures. It can be caused by a variety of reasons, including head trauma, brain tumors and birth injuries. It can also be caused by a disease or illness that affects the blood supply to the brain, such as ischemic stroke.
Symptoms of temporal lobe epilepsy may include loss of memory, trouble speaking or understanding language, jerking movements, a sense of smell or taste that is unusual and the ability to be stung by something, such as mosquitos. Sometimes a person has a fixed stare during a seizure. Other times they are unaware or confused about what’s happening around them, have a fumbling with fingers or lip-smacking movement or speak gibberish. Some people lose the ability to move or breathe during a seizure.
If a person doesn’t get their seizures under control with medicine, they can develop a range of other problems that impact their quality of life. These can include difficulty working, anxiety about having another seizure, fear of going out in public and a lack of socialization that leads to isolation. People can also become frustrated, as they don’t understand why they have seizures. They can also be teased or embarrassed about their condition.
Medicines are the first line of treatment for temporal lobe epilepsy. However, some people don’t achieve seizure control with medication alone and have to stop taking it due to side effects such as fatigue or weight gain. In these cases, surgery can help.
Doctors diagnose a person with temporal lobe epilepsy by listening to how the person describes their seizures. Then they use tests to check for abnormalities in the brain such as magnetic resonance imaging (MRI) and positron emission tomography (PET). An MRI uses powerful magnets and radio waves to create images of the brain that can pinpoint where the seizures are coming from. PET scans use a low-dose of a radioactive substance that helps to highlight active areas in the brain.
If a person with temporal lobe seizures has a hippocampal sclerosis lesion on their MRI and EEGs show that their seizures start in the medial temporal lobe, they can be cured by having surgery to remove the area of the brain responsible for their seizures. This is called temporal lobectomy and it has very good success rates. In one study, a large percentage of people were seizure-free at a year after surgery. Other studies suggest that careful patient selection pushes the success rate even higher. Other less invasive procedures can be used in some patients as well, such as vagus nerve stimulation or responsive neurostimulation. These involve placing electrodes in the brain. However, they don’t have the same long-term results as temporal lobectomy and they have higher risks of complications.