Seizure

Temporal Lobe Seizure

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Temporal Lobe Seizure, Temporal Lobe Epilepsy, Psychomotor Seizure

  • See Also
  1. Complex Seizure
  • Epidemiology
  1. Most common complex Seizure
  • Pathophysiology
  1. Starts in Temporal Lobe
  2. Frontal Lobe commonly involved
  • Symptoms
  1. Complex and variable
  2. Aura may be present
    1. Gastrointestinal symptoms
    2. Fear
  • Signs
  1. Motionless stare heralds Seizure
  2. Consciousness is always impaired
  3. Automatisms
  4. Oral facial moves
  5. Fumbling or picking movements
  6. Duration: 30 seconds to 2 minutes
  7. May progress to Generalized Tonic Clonic Seizure
  • Differential diagnosis
  1. Absence Seizure (typical or atypical)
  2. Behavioral disturbance
  3. Migraine Headache
  • Management
  1. Medications (60-70% response rate)
    1. Carbamazepine (Tegretol)
    2. Phenytoin (Dilantin)
  2. Surgery: Temporal Lobe Resection
    1. Indicated for failed medical therapy after 1-2 years
    2. Efficacy
      1. Better TLE Seizure control than with anticonvulsant
      2. Wiebe (2001) N Engl J Med 345:311-8 [PubMed]