Temporal Lobe Epilepsy Case Study

Temporal lobe epilepsy (TLE) is a type of epilepsy characterized by recurrent, unprovoked seizures that originate from the temporal lobe structures (Ko & Benbadis, 2014). The temporal lobes are important for memory, hearing, and language (Kuzniecky & Jackson, 2005). TLE is the most common form of focal epilepsy (Jutila et al., 2002). TLE is also the most common type of epilepsy requiring surgical treatment (Janszky et al., 2005). The seizures associated with TLE consist of simple partial seizures and complex partial seizures. One particular type of simple partial seizure associated with TLE is an aura. An aura can be correlated with a warning, because it is a sensation which people get before another seizure. During a simple partial seizure,

Hippocampal sclerosis, which involves hippocampal cell loss in the CA1 and CA3 regions, is found in approximately two thirds of patients with TLC but is not considered an etiology. Infections such as bacterial meningitis and neurocysticercosis can be the etiology of TLE in one patient while trauma that produces a contusion or hemorrhage resulting in cortical scarring can be the etiology of TLE in another patient. Hamaratomas, malignancies, paraneoplastic, and vascular abnormalities are also known etiologies of TLE. Febrile seizures are associated with TLE, but whether or not they are an etiology of it is controversial (Ko & Benbadis,

The best way to define the epileptogenic lesion is to use a high-resolution MRI. The high-resolution MRI looks at where the lesion is located and then video-EEG monitoring verifies that the lesion is the cause of the epileptic seizures (Rosenow & Lüders, 2001). The image an MRI produces can indicate structural abnormalities other than lesions, such as cortical scarring from trauma or damage from past seizures (Engel, 1996, Quarato et al., 2005). Video-EEG monitoring is typically evaluated by three aspects: long-term interictal EEG, seizure semiology, and ictal EEG. A long-term EEG detects a presence or absence of temporal abnormalities. A presence of temporal abnormalities result in focal slow waves or epileptiform spikes at electrodes near the temporal lobe. Seizure semiology is defined at signs that a seizure is going to occur on the EEG. An ictal EEG shows when an actually seizure occurs on the EEG (Uijl et al.,