temporal lobe epilepsy

 Epilepsy of the temporal lobe

The brain is divided into sections called lobes - frontal, temporal, occipital and parietal. When the origin of recurrent crises can be traced back to the temporal lobe, we speak of epilepsy of the temporal lobe. Temporal lobe epilepsy can be caused by brain damage, such as traumatic damage or infection. There are many other causes, including brain tumors, vascular malformations and developmental abnormalities.
Symptoms
Partial (focal) seizures can occur in patients of any age, with or without aura (a neurological symptom, such as a sense of fear, an unpleasant odor or a change in perception), and may have a variety of symptoms, including cloning , abnormal movements and anomalous sensations. Sometimes these partial crises can progress to generalized crises affecting the whole brain.
Mesial temporal sclerosis usually results in partial (or focal) epilepsy. This epileptic disorder can cause a variety of symptoms including strange feelings, changes in behavior or emotions, muscle spasms, or convulsions. Crises are usually localized, but they can spread and become generalized crises, which involve the entire brain and can cause a sudden loss of vigilance or consciousness.
Diagnosis
Diagnostic techniques, such as electroencephalogram (EEG), video-EEG telemetry (vEEG), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and computerized tomography single photon emission (SPECT), are used to evaluate and visualize the anomalies and structural problems associated with epilepsy that may be the objectives of surgery. Functional tests, including neuropsychological tests, functional magnetic resonance imaging (fMRI), and WADA tests, can be used prior to surgery to define vital brain regions and the risks associated with epileptic zone removal.
Treatment
Although some patients may control seizures with anticomizial drug therapy, temporal lobe epilepsy is a condition that is often treatable with surgery. Because seizures are localized and have an identifiable site in the brain, the removal of all or part of the temporal lobe, called temporal lobectomy, can often resolve convulsions altogether.
Temporal lobectomy is the most common epilepsy surgery and is associated with high success rates and low complication rates. A recent study reported a success rate (defined by the number of patients without a seizure for a year) close to 60 percent, compared to 8 percent for patients treated only with drug therapy. Clinical experience and accurate patient selection can further increase this percentage. Other studies have reported higher success rates for patients with carefully selected temporal lobe epilepsy.
Some doctors still consider temporal lobectomy to be an extreme procedure, considering the risk of side effects, including memory loss, visual disturbances and emotional changes associated with the removal of brain tissue. However, such side effects are minimized by careful patient selection and a series of neurological tests that indicate where to locate the resection to minimize the effects on neurological function. Furthermore, experts say that the part of the brain that is removed already behaves abnormally, and therefore its removal does not have a negative effect on brain function.
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