Temporal Lobe Epilepsy

What is temporal lobe epilepsy?
Temporal lobe epilepsy is a form of epilepsy where seizures start in the temporal lobe of the brain.  The temporal lobe is the part of the brain that processes emotions. There's a temporal lobe on each side of the head, just above the ears.

What are temporal lobe epilepsy seizures like?
Sometimes temporal lobe seizures are very mild. Other times they're much more intense. Just before a seizure, a child may experience unusual sensations and emotions or hallucinations with voices, music, people, smells or tastes. This is called an aura. The aura is actually a small seizure itself.

The aura is often followed by a partial seizure. There are two types of partial seizures:

• Complex partial seizures. This is the most common type of seizure in children with temporal lobe epilepsy. The seizure usually starts with a blank stare and a loss of contact with surroundings. Many children perform repetitive, automatic movements, such as lip smacking, clapping or moving their head. A child may walk around or become aggressive without any awareness of what he or she is doing. After the seizure, the child will not remember what happened.
• Simple partial seizures. These seizures affect movement and emotions. Children remain aware of what's going on, but may not be able to speak or move. In other cases, they can talk normally. Uncontrolled movements can occur in just about any part of the body. Children may suddenly feel fear, anger or joy. They may experience sensations - smells and tastes - that aren't really there. Things may look distorted to them. After the seizure, the child will remember what happened.

In some children, seizures spread from the temporal lobe to a wider portion of the brain. The result of this is a convulsive (grand mal) seizure.

What causes temporal lobe seizures?
Temporal lobe seizures can be the result of damage to the temporal lobe of the brain. This damage can be caused by:

• A head injury
• Infection
• Lack of oxygen
• Brain tumors
• Birth defects
• Stroke

In many cases, the cause of temporal lobe seizures is unknown.

How is temporal lobe epilepsy diagnosed?
Temporal lobe epilepsy can be difficult to diagnose because temporal lobe seizures may not show up on an EEG. The diagnosis is often made through observation of symptoms or the use of brain imaging technology that can detect abnormalities in the brain.

The multi-disciplinary epilepsy team at Le Bonheur Children's Medical Center can perform an extensive evaluation to determine whether your child has temporal lobe epilepsy.

What is the treatment for temporal lobe epilepsy?
Most children who experience temporal lobe seizures are treated with medication. About half of children with temporal lobe epilepsy eventually outgrow it.

Some children are put on a ketogenic diet. This is a very strict diet that's high in fats and low in carbohydrates and protein. This diet produces a by-product in the body called ketones. High concentrations of ketones can control seizures.

Some children, however, do not respond to the usual medical treatments. This is called intractable epilepsy. These children may benefit from surgery.

Surgery for temporal lobe seizures has the highest success rate of all epilepsy surgery. Resective surgery removes the area of the brain or the defect that causes the seizures.

Why Le Bonheur Children's?
The epilepsy team at Le Bonheur Children's Medical Center includes some of the most respected pediatric epilepsy specialists in the United States. The hospital's Comprehensive Epilepsy Program is a key component of the hospital's Neuroscience Institute, a center of excellence dedicated to the evaluation and treatment of neurological disorders in children and adolescents. Children from across the country visit Le Bonheur each year to be treated at the Institute.