Temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for short-term memory. Some symptoms of a temporal lobe seizure may be related to these functions, including having odd feelings — such as euphoria, deja vu or fear.
Temporal lobe seizures are sometimes called focal seizures with impaired awareness. Some people remain aware of what's happening, but during more-intense seizures, you might look awake but be unresponsive. Your lips and hands may make purposeless, repetitive movements.
Temporal lobe seizures may stem from an anatomical defect or scar in your temporal lobe, but the cause is often unknown. Temporal lobe seizures are treated with medication. For some people who don't respond to medication, surgery may be an option.
An unusual sensation (aura) may precede a temporal lobe seizure, acting as a warning. Not everyone who has temporal lobe seizures has auras, and not everyone who has auras remembers them.
The aura is actually the first part of a focal seizure before consciousness is impaired. Examples of auras include:
Sometimes temporal lobe seizures impair your ability to respond to others. This type of temporal lobe seizure usually lasts 30 seconds to two minutes. Characteristic signs and symptoms include:
After a temporal lobe seizure, you may have:
In extreme cases, what starts as a temporal lobe seizure evolves into a generalized tonic-clonic (grand mal) seizure — featuring convulsions and loss of consciousness.
Seek immediate medical help if any of the following occurs:
If you experience a seizure for the first time, seek medical advice.
Seek medical advice in these circumstances:
Often, the cause of temporal lobe seizures remains unknown. However, they can be a result of a number of factors, including:
During normal waking and sleeping, your brain cells produce varying electrical activity. If the electrical activity in many brain cells becomes abnormally synchronized, a convulsion or seizure may occur.
If this happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that originates in one of the temporal lobes.
Over time, repeated temporal lobe seizures can cause the part of the brain that's responsible for learning and memory (hippocampus) to shrink. Brain cell loss in this area may cause memory problems.
After a seizure, your doctor will thoroughly review your symptoms and medical history. Your doctor may order several tests to determine the cause of your seizure and evaluate how likely it is that you'll have another one.
Tests may include:
Not everyone who has one seizure will have another one. Because a seizure can be an isolated incident, your doctor may not decide to start treatment until you've had more than one.
The optimal goal in seizure treatment is to find the best possible therapy to stop seizures, with the fewest side effects.
Many medications are available to treat temporal lobe seizures. However, many people don't achieve seizure control with medications alone, and side effects, including fatigue, weight gain and dizziness, are common.
Discuss possible side effects with your doctor when deciding about treatment options. Also ask what effect your seizure medications and other medications you take, such as oral contraceptives, may have on each other.
When anti-seizure medications aren't effective, other treatments may be an option:
Surgery. The goal of surgery is to stop seizures from happening. This is often done through a traditional surgery, where surgeons operate to remove the area of the brain where seizures begin. In certain people, surgeons may be able to use MRI-guided laser therapy as a less invasive way to destroy the area of damaged tissue that causes seizures.
Surgery works best for people who have seizures that always originate in the same place in their brains. Surgery generally isn't an option if your seizures come from more than one area of the brain, your seizure focus can't be identified or your seizures come from a region of the brain that performs vital functions.
Women who've had previous seizures typically are able to have healthy pregnancies. Birth defects related to certain medications can sometimes occur.
In particular, valproic acid (Depakene) — one possible medication for generalized seizures — has been associated with cognitive deficits and neural tube defects, such as spina bifida. The American Academy of Neurology recommends that women avoid using valproic acid during pregnancy because of risks to the baby.
Discuss these risks with your doctor. Because of the risk of birth defects, and because pregnancy can alter medication levels, preconception planning is particularly important for women who've had seizures.
In some cases, it may be appropriate to change the dose of seizure medication before or during pregnancy. Medications may be switched in rare cases.
It's also important to know that some anti-seizure medications can alter the effectiveness of oral contraceptives — a form of birth control — and some oral contraceptives can speed up the absorption of seizure medications. If contraception is a high priority, check with your doctor to evaluate whether your medication interacts with your oral contraceptive, and if other forms of contraception need to be considered.
Here are some steps you can take to help with seizure control:
Seizures don't usually result in serious injury, but if you have recurrent seizures, injury is a possibility. These steps can help you avoid injury during a seizure:
It's helpful to know what to do if you witness someone having a seizure. If you're at risk of having seizures in the future, pass this information along to family, friends and co-workers so that they know what to do if you have a seizure.
To help someone during a seizure:
Even after they're under control, seizures can affect your life. Temporal lobe seizures may present even more of a coping challenge because people may not recognize the unusual behavior as a seizure. Children may get teased or be embarrassed by their condition, and living with the constant threat of another seizure may frustrate children and adults.
Your family can provide much-needed support. Tell them what you know about your seizure disorder. Let them know they can ask you questions, and be open to conversations about their worries. Help them understand your condition by sharing any educational materials or other resources that your doctor has given you.
Meet with your supervisor and talk about your seizure disorder and how it affects you. Discuss what you need from your supervisor or co-workers if a seizure happens while at work. Consider talking with your co-workers about seizure disorders — you can widen your support system and bring about acceptance and understanding.
Remember, you don't have to go it alone. Reach out to family and friends. Ask your doctor about local support groups or join an online support community. Don't be afraid to ask for help. Having a strong support system is important to living with any medical condition.
In some cases, seizures need immediate medical attention, and there's not always time to prepare for an appointment.
In other cases, your first appointment to evaluate a seizure may be with your family doctor or a general practitioner. Or you may be referred to a specialist, such as a doctor trained in brain and nervous system conditions (neurologist) or a neurologist trained in epilepsy (epileptologist).
To prepare for your appointment, consider what you can do to get ready and understand what to expect from your doctor.
For seizures, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
Your doctor is likely to ask you a number of questions:
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