Temporal lobe epilepsy

---

• Epidemiology: most common form of epilepsy
  • ∼ 40% of all epilepsy cases
  • ∼ 70% of focal epilepsy cases
• Etiology
  • Hippocampal sclerosis: found in approx. 70% of patients suffering from temporal lobe epilepsy that is resistant to pharmacotherapy
  • Encephalitis (e.g., herpes simplex encephalitis)
  • Developmental disorders
  • Neurodegenerative disorders
  • Tumors
• Clinical features: Seizures commonly occur in clusters, last approx. 30 seconds to 2 minutes, and follow a specific sequence.
  1. Aura
     • Visceral, olfactory, or auditory
     • Feelings of familiarity or unfamiliarity and “dreamy states”
  2. Focal seizure with impaired awareness (complex partial seizure)
     • Motor symptoms
       • Typically oral alimentary automatisms (e.g., lip-smacking)
     • Autonomic symptoms
     • Altered mental status
       • Children appear absent-minded (e.g., staring ahead, unresponsive when spoken to)
       • No loss of consciousness
  3. Postictal phase
     • Confusion and tiredness (common)