Epilepsy, temporal-lobe

Epilepsy characterized by abnormal electrical activity in the temporal lobe of the brain. This activity does not cause grand mal seizures, but rather causes unusual behaviors and patterns of cognition. Seizures in temporal-lobe epilepsy often start in childhood and may present as: {{}}Simple partial seizures with a preserved awareness of self and surroundings (also known as an aura or warning). Patients commonly experience a variety of psychic, gustatory, olfactory, and autonomic symptoms. Complex partial seizures in which awareness is impaired. Patients are disabled. They lose awareness and tend to have a motionless stare accompanied by automatisms — stereotyped, repetitive, involuntary movements such as lip smacking, chewing, picking at objects, scratching, and gesturing. Generalized convulsions also occur in some temporal-lobe epilepsy patients. Temporal-lobe epilepsy is difficult to diagnose, because temporal lobe seizures may not show up on an EEG. Diagnosis may instead be by observation of symptoms or through the use of brain imaging technology. Temporal lobe epilepsy can be treated with the same types of anti-seizure medications used for other forms of epilepsy. However, such medical treatment may be futile. Surgery is an important option. In a randomized controlled trial, a year after surgery 58% of patients treated surgically as compared with 8% of those treated medically were free of complex partial and generalized seizures, and the quality of life was significantly better in the surgical group. Surgery may thus control seizures and preclude unnecessary disability. The "father of English neurology" Hughlings Jackson (1835-1911) described a classic case of temporal-lobe epilepsy in "Dr. Z." Dr. Z.'s disease destroyed his career and ended in his death.