Temporal Lobe Epilepsy (Mesial, Lateral) ; Definition, causes, Symptoms, Diagnosis, Treatment

Temporal Lobe Epilepsy (TLE) is the most common form of focal epilepsy, originating in the temporal lobes of the brain. It can be classified into two main types: Mesial Temporal Lobe Epilepsy (MTLE) and Lateral Temporal Lobe Epilepsy (LTLE).

Mesial Temporal Lobe Epilepsy (MTLE)
Location: MTLE involves the medial or internal structures of the temporal lobe, such as the hippocampus, amygdala, and parahippocampal gyrus.

Symptoms: Common symptoms include auras (such as a rising epigastric sensation, déjà vu, or fear), focal impaired awareness seizures, and automatisms (repetitive movements like lip-smacking or hand fumbling).

Causes: MTLE is often associated with hippocampal sclerosis, which is scarring or hardening of the hippocampus. It can also be linked to a history of febrile seizures or brain injury.

Diagnosis: MRI scans often show abnormalities in the hippocampus, and EEG recordings can detect characteristic seizure patterns.

Treatment: Antiepileptic drugs (AEDs) are commonly used, but surgery (such as temporal lobectomy or amygdalohippocampectomy) may be considered for drug-resistant cases2.

Lateral Temporal Lobe Epilepsy (LTLE)
Location: LTLE involves the outer or lateral parts of the temporal lobe, including the neocortex.

Symptoms: Symptoms may include auditory hallucinations, visual distortions, and focal impaired awareness seizures. LTLE can also cause language disturbances if the dominant hemisphere is affected.

Causes: LTLE can be caused by tumors, cortical dysplasia, vascular malformations, or traumatic brain injury.

Diagnosis: MRI and EEG are used to identify structural abnormalities and seizure activity in the lateral temporal lobe.

Treatment: Similar to MTLE, AEDs are the first line of treatment, and surgery may be considered for refractory cases

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