Padaczka skroniowa
Etiologia i przyczyny
Padaczka skroniowa (TLE) jest najczęstszą formą padaczki ogniskowej, dotykającą około 60% pacjentów z padaczką, co przekłada się na około 50 milionów osób na świecie. Etiologia TLE jest złożona i obejmuje stwardnienie hipokampa (HS) – najczęstszą przyczynę (około 70% przypadków operowanych z powodu lekoopornej padaczki), guzy mózgu (około 10%), dysplazję korową (5-10%), malformacje naczyniowe (około 5%), urazy mózgu, infekcje OUN oraz czynniki genetyczne i autoimmunologiczne. HS charakteryzuje się utratą neuronów i glii w hipokampie, prowadząc do jego zwłóknienia i zaniku, często powiązanym z przedłużającymi się drgawkami gorączkowymi w dzieciństwie oraz mutacjami genów takich jak SCN1A. Urazy mózgu, infekcje (np. wirus HSV, HHV-6B) oraz anomalie naczyniowe i nowotwory również odgrywają istotną rolę w patogenezie TLE. Wyróżnia się dwa podtypy: przyśrodkową (MTLE, 80% przypadków) i boczną (LTLE), różniące się etiologią i rokowaniem.
- Etiologia padaczki skroniowej
- Stwardnienie hipokampa (sclerosis hippocampi)
- Urazy mózgu
- Infekcje ośrodkowego układu nerwowego
- Nieprawidłowości naczyniowe
- Guzy mózgu
- Dysplazja korowa i zaburzenia rozwojowe mózgu
- Czynniki genetyczne
- Padaczka autoimmunologiczna
- Inne przyczyny
- Padaczka przyśrodkowa i boczna płata skroniowego
- Różnice w etiologii w zależności od wieku
- Padaczka skroniowa bez widocznych zmian w obrazowaniu
- Wpływ etiologii na rokowanie i leczenie
- Podsumowanie etiologii padaczki skroniowej
Etiologia padaczki skroniowej
Padaczka skroniowa (ang. Temporal Lobe Epilepsy, TLE) stanowi najczęstszą formę padaczki ogniskowej, dotykając około 60% wszystkich pacjentów z padaczką na świecie. Szacuje się, że choroba ta dotyka około pięćdziesięciu milionów osób. Napady padaczkowe w padaczce skroniowej rozpoczynają się w płatach skroniowych mózgu, które są obszarami najbardziej epileptogennymi w mózgu człowieka. Nadmierna aktywność elektryczna w neuronach płata skroniowego prowadzi do niekontrolowanego wyładowania elektrycznego, które zamiast kierowania sygnałów do odpowiednich części mózgu, powoduje ich chaotyczne rozprzestrzenianie się.12345
Etiologia padaczki skroniowej jest złożona i różnorodna. W około 50% przypadków przyczyna pozostaje nieznana (idiopatyczna lub kryptogenna), natomiast w pozostałych przypadkach można zidentyfikować konkretne czynniki etiologiczne.678
Stwardnienie hipokampa (sclerosis hippocampi)
Stwardnienie hipokampa (ang. hippocampal sclerosis, HS) stanowi najczęstszą przyczynę padaczki skroniowej i występuje u około 70% pacjentów poddawanych zabiegom chirurgicznym z powodu lekoopornej padaczki skroniowej. Charakteryzuje się utratą neuronów i komórek gleju w obszarze hipokampa, prowadząc do jego zwłóknienia i zaniku. Stwardnienie hipokampa jest częścią szerszego zjawiska określanego jako przyśrodkowe stwardnienie skroniowe (mesial temporal sclerosis, MTS).9101112
Dokładna przyczyna powstawania stwardnienia hipokampa nie jest w pełni wyjaśniona, ale istnieją hipotezy sugerujące związek z:
- Przedłużającymi się drgawkami gorączkowymi w okresie dzieciństwa
- Powtarzającą się aktywnością napadową, która powoduje wysokie zapotrzebowanie metaboliczne neuronów prowadzące do ich zniszczenia
- Mutacjami genów, np. genu SCN1A, który wiązany jest z drgawkami gorączkowymi i następczym stwardnieniem hipokampa
Istnieje interesująca zależność pomiędzy stwardnieniem hipokampa a napadami gorączkowymi. Chociaż tylko 10-15% dzieci z drgawkami gorączkowymi rozwija później padaczkę, obserwuje się wyraźną korelację między ciężkimi lub przedłużającymi się (trwającymi ponad 15 minut) drgawkami gorączkowymi a późniejszym rozwojem padaczki skroniowej. Związek ten może mieć podłoże genetyczne, zwiększające podatność na uszkodzenie hipokampa w następstwie drgawek gorączkowych.161718
Urazy mózgu
Urazy mózgu stanowią istotny czynnik etiologiczny padaczki skroniowej. Do urazów mogących przyczynić się do rozwoju TLE należą:
- Urazy czaszkowo-mózgowe, szczególnie te powodujące utratę przytomności dłuższą niż 30 minut
- Urazy okołoporodowe, w tym trudne porody z użyciem kleszczy
- Obrażenia prowadzące do stłuczenia lub krwawienia śródmózgowego
- Urazy skutkujące encefalomalacją (zmiękczeniem tkanki mózgowej) lub bliznowaceniem kory mózgowej
Osoby, które doświadczyły jakiegokolwiek urazu mózgu we wczesnym okresie życia, mają wyższe ryzyko rozwoju padaczki. Mechanizm patogenetyczny polega na powstawaniu blizn w obrębie płata skroniowego, które stają się ogniskami epileptogennymi. Tworzenie się tkanki bliznowatej może wywołać zaburzenia w normalnym przepływie impulsów elektrycznych, prowadząc do napadów padaczkowych.2223
Infekcje ośrodkowego układu nerwowego
Infekcje ośrodkowego układu nerwowego mogą prowadzić do padaczki skroniowej poprzez uszkodzenie struktur płata skroniowego. Do najczęstszych infekcji przyczyniających się do rozwoju TLE należą:
- Zapalenie mózgu (encephalitis) – szczególnie wywołane wirusem opryszczki (HSV), które może selektywnie uszkadzać płaty skroniowe
- Zapalenie opon mózgowo-rdzeniowych (meningitis)
- Ropień mózgu
- Neurocysticerkoza
Szczególną uwagę należy zwrócić na zapalenie mózgu wywołane wirusem opryszczki (HSV), które wykazuje tropizm do struktur przyśrodkowej części płata skroniowego. Niedawne badania sugerują również potencjalną rolę wirusa HHV-6B (Human Herpesvirus-6B) w etiologii przyśrodkowej padaczki skroniowej. Wirus ten jest znany z wywoływania drgawek gorączkowych u małych dzieci, a wysokie miano wirusa HHV-6B zostało udokumentowane w tkance mózgowej usuniętej od pacjentów z MTLE.2829
Nieprawidłowości naczyniowe
Różne anomalie naczyniowe mózgu mogą być przyczyną padaczki skroniowej:
- Malformacje tętniczo-żylne (arteriovenous malformations, AVM)
- Naczyniaki jamiste (cavernous angiomas)
- Udar mózgu (zarówno niedokrwienny jak i krwotoczny)
- Nieprawidłowo uformowane naczynia krwionośne
Anomalie naczyniowe mogą prowadzić do przewlekłego niedokrwienia tkanki mózgowej lub mikrowylewów, powodując lokalne uszkodzenia płata skroniowego. U osób starszych (powyżej 35 roku życia) udar mózgu jest wiodącą przyczyną padaczki. Zmiany naczyniowe stanowią około 5% przypadków padaczki skroniowej.3334
Guzy mózgu
Nowotwory mózgu mogą być przyczyną padaczki skroniowej, stanowiąc około 10% przypadków. Do guzów najczęściej powodujących TLE należą:
- Oponiaki (meningioma)
- Glejaki (glioma)
- Ganglioneuroblastoma
- Hamartoma
- Nowotwory glejowo-neuronalne (glioneuronal tumors)
Guzy mogą wywoływać napady padaczkowe poprzez ucisk na otaczającą tkankę mózgową, zaburzenie lokalnego ukrwienia lub bezpośrednie drażnienie kory mózgowej. Warto zauważyć, że w niektórych przypadkach napad padaczkowy może być pierwszym objawem guza mózgu, co podkreśla znaczenie wczesnej diagnostyki obrazowej u pacjentów z nowo rozpoznaną padaczką.38
Dysplazja korowa i zaburzenia rozwojowe mózgu
Dysplazja korowa ogniskowa (Focal Cortical Dysplasia, FCD) i inne zaburzenia rozwojowe mózgu odpowiadają za 5-10% przypadków padaczki skroniowej. Są to wady powstające w okresie rozwoju embrionalnego, prowadzące do nieprawidłowego ukształtowania kory mózgowej.3940
Malformacje rozwojowe kory mózgowej (Malformations of Cortical Development, MCD) obejmują nieprawidłowości w rozwoju kory mózgowej, dotyczące procesów takich jak regionalizacja, proliferacja komórek, migracja neuronalna oraz organizacja korowa. Dysplazja korowa ogniskowa jest podtypem MCD, który wywołuje przewlekłą, oporną na leczenie farmakologiczne padaczkę w populacji pediatrycznej i jest częstą przyczyną padaczki u dorosłych.41
Szczególnym przypadkiem jest rozproszenie komórek ziarnistych (Granule Cell Dispersion, GCD) w zakręcie zębatym, obserwowane w stwardnieniu hipokampa, które może być następstwem wzmożonej proliferacji prekursorów komórek ziarnistych w wyniku napadów padaczkowych.42
Czynniki genetyczne
Genetyczne uwarunkowania padaczki skroniowej obejmują zarówno formy rodzinne, jak i sporadyczne z komponentem genetycznym:
- Rodzinna padaczka płata skroniowego (Familial Temporal Lobe Epilepsy, FTLE) – dziedziczona w sposób autosomalny dominujący
- Autosomalnie dominująca padaczka z objawami słuchowymi (Autosomal Dominant Epilepsy with Auditory Features, ADEAF) – związana z mutacjami w genach LGI1 lub RELN
- Mutacje genu KCC2 (neuron-specific type 2 K+/Cl cotransporter) – prowadzące do utraty funkcji i związane z MTLE ze stwardnieniem hipokampa
- Mutacje genu TSC2 – powodujące nadpobudliwość neuronów glutaminergicznych
- Mutacje genu SCN1A – związane z drgawkami gorączkowymi i stwardnieniem hipokampa
Badania wykazały, że nawet jedna piąta nowo zdiagnozowanych przypadków MTLE bez widocznych zmian w obrazowaniu może mieć komponent rodzinny. Przypadki rodzinnej MTLE wykazują złożony wzorzec dziedziczenia i zazwyczaj nie wykazują stwardnienia przyśrodkowej części płata skroniowego w badaniach obrazowych.47
Gen LGI1 jest szczególnie istotny w kontekście padaczki skroniowej, ponieważ koduje białko zwane epitempiną (leucine-rich glioma inactivated 1), które odgrywa kluczową rolę w regulacji kanałów potasowych pomagających kontrolować komunikację między komórkami w mózgu.4849
Padaczka autoimmunologiczna
W ostatnich latach zwraca się uwagę na autoimmunologiczne podłoże niektórych przypadków padaczki skroniowej:
- Limbiczne zapalenie mózgu (Limbic Encephalitis) – związane z przeciwciałami przeciwko strukturom układu limbicznego
- Przeciwciała anty-Hu – występujące w zespołach paraneoplastycznych
- Przeciwciała przeciwko receptorom NMDA – szczególnie częste u młodych kobiet
Autoimmunologiczne zapalenie mózgu może być trudne do zdiagnozowania, gdyż może nie pozostawiać specyficznych śladów w badaniach obrazowych mózgu lub ślady te są trudne do zidentyfikowania. Stanowi to jedno z wyzwań w diagnostyce padaczki skroniowej bez widocznych zmian w obrazowaniu (non-lesional TLE).53
Inne przyczyny
Inne, rzadziej występujące przyczyny padaczki skroniowej obejmują:
- Przepukliny bieguna skroniowego (temporal pole encephalocele) – trudne do rozpoznania w standardowym obrazowaniu
- Powiększenie ciała migdałowatego (amygdala enlargement) – podtyp padaczki skroniowej bez stwardnienia hipokampa
- Zespół „temporal plus” – gdy obszar epileptogenny wykracza poza granice płata skroniowego
- Zespół odstawienia alkoholu – może wyzwalać napady padaczkowe w obrębie płata skroniowego
- Zaburzenia metaboliczne – takie jak hipoglikemia, hiponatremia, hiperkalcemia lub hipokalcemia
- Reakcje na leki – np. na fenotiazyny, izoniazyd, trójpierścieniowe leki przeciwdepresyjne
Padaczka przyśrodkowa i boczna płata skroniowego
Padaczka skroniowa może być podzielona na dwa główne podtypy w zależności od lokalizacji ogniska padaczkowego:
- Przyśrodkowa padaczka płata skroniowego (Mesial Temporal Lobe Epilepsy, MTLE) – rozpoczyna się w wewnętrznym obszarze płata skroniowego, obejmującym hipokamp, zakręt przyhipokampowy i ciało migdałowate. Stanowi około 80% wszystkich przypadków padaczki skroniowej.
- Boczna padaczka płata skroniowego (Lateral Temporal Lobe Epilepsy, LTLE) – rozpoczyna się w zewnętrznych obszarach płata skroniowego.
Te dwa podtypy różnią się etiologią, objawami klinicznymi i rokowaniem. MTLE jest najczęściej związana ze stwardnieniem hipokampa, podczas gdy LTLE częściej wiąże się z guzami, dysplazją korową lub malformacjami naczyniowymi.61
Różnice w etiologii w zależności od wieku
Przyczyny padaczki skroniowej różnią się w zależności od wieku wystąpienia:
- U dzieci: drgawki gorączkowe, infekcje OUN, zaburzenia rozwojowe mózgu, urazy okołoporodowe, nieprawidłowości genetyczne
- U młodych dorosłych: stwardnienie hipokampa, urazy głowy, guzy, malformacje naczyniowe
- U osób starszych: choroby naczyniowe mózgu (udary), guzy, choroby neurodegeneracyjne (choroba Alzheimera, otępienie wielozawałowe)
Padaczka skroniowa najczęściej rozpoczyna się między 10 a 20 rokiem życia, choć może wystąpić w każdym wieku. Interesującym jest fakt, że padaczka skroniowa z powiększeniem ciała migdałowatego charakteryzuje się późniejszym początkiem, co sugeruje łagodniejszą i wolniej rozwijającą się epileptogenność w obrębie ciała migdałowatego.646566
Padaczka skroniowa bez widocznych zmian w obrazowaniu
W około 20-30% przypadków lekoopornej padaczki skroniowej, w badaniach obrazowych mózgu (MRI) nie stwierdza się żadnych zmian epileptogennych. Ta tzw. padaczka skroniowa bez widocznych zmian w obrazowaniu (non-lesional TLE) stanowi istotne wyzwanie diagnostyczne i terapeutyczne.67
Etiologia padaczki skroniowej bez widocznych zmian w obrazowaniu może obejmować:
- Autoimmunologiczne zapalenie mózgu
- Genetycznie uwarunkowaną padaczkę skroniową
- Ukryte przepukliny bieguna skroniowego
- Subtelne zmiany strukturalne niewidoczne w standardowym obrazowaniu MRI
- Zaburzenia czynnościowe bez wyraźnych zmian strukturalnych
Warto podkreślić, że postępy w technikach obrazowania i diagnostyce molekularnej stopniowo zmniejszają odsetek przypadków padaczki sklasyfikowanych jako „bez widocznych zmian” lub „o nieznanej etiologii”.70
Wpływ etiologii na rokowanie i leczenie
Etiologia padaczki skroniowej ma istotny wpływ na rokowanie i wybór metody leczenia:
- Pacjenci ze stwardnieniem hipokampa mają najlepsze wyniki po leczeniu operacyjnym – około 70% osiąga długoterminową wolność od napadów
- Padaczka skroniowa związana z guzami mózgu wymaga zazwyczaj leczenia neurochirurgicznego, które jednocześnie leczy przyczynę i objawy
- Przypadki związane z dysplazją korową również dobrze odpowiadają na leczenie operacyjne
- Autoimmunologiczne formy padaczki skroniowej mogą wymagać leczenia immunomodulującego
- Padaczka skroniowa o etiologii genetycznej często wymaga wielolekowej terapii przeciwpadaczkowej
Interesującym jest, że według niektórych badań, wyniki leczenia operacyjnego padaczki skroniowej są podobne niezależnie od etiologii. Jedno z badań wykazało, że około 73% pacjentów z padaczką skroniową osiąga korzystny wynik po operacji, niezależnie od pierwotnej przyczyny.74
W przypadku padaczki skroniowej związanej ze stwardnieniem hipokampa, lobektomia skroniowa jest najczęstszym zabiegiem chirurgicznym i wiąże się z wysokim odsetkiem powodzeń i niskim ryzykiem powikłań. Badania wykazały, że około 60% pacjentów pozostaje wolnych od napadów rok po operacji, w porównaniu do zaledwie 8% pacjentów leczonych wyłącznie farmakologicznie.75
Podsumowanie etiologii padaczki skroniowej
Etiologia padaczki skroniowej jest złożona i wieloczynnikowa. Najczęstsze przyczyny to stwardnienie hipokampa (około 70% przypadków), guzy mózgu (około 10%), dysplazja korowa (5-10%), malformacje naczyniowe (około 5%) oraz urazy mózgu, infekcje i czynniki genetyczne. W około połowie przypadków etiologia pozostaje nieznana.7677
Zrozumienie różnorodności etiologicznej padaczki skroniowej ma kluczowe znaczenie dla właściwej diagnostyki, efektywnego leczenia oraz określenia rokowania dla pacjentów. Postępy w badaniach genetycznych, immunologicznych i metodach obrazowania stopniowo przyczyniają się do lepszego poznania przyczyn tej choroby, co może prowadzić do opracowania bardziej spersonalizowanych i skutecznych strategii terapeutycznych w przyszłości.787980
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Materiały źródłowe
- #1 Temporal Lobe Epilepsy (TLE): Causes, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/17778-temporal-lobe-seizures
Temporal lobe epilepsy is a seizure-causing condition that starts in your temporal lobe. […] Temporal lobe epilepsy (TLE) is a type of epilepsy where seizures begin in the temporal lobe. Seizures are the result of abnormal electrical activity in your brain. […] Neurons (nerve cells) miscommunicating in your temporal lobe cause temporal lobe epilepsy. Neurons send electrical signals to different parts of your brain. When a seizure happens, neurons uncontrollably fire off signals instead of directing them to where they need to go. […] Some of the most common causes of temporal lobe epilepsy include: Hippocampal sclerosis (neuron and glial cell loss in the hippocampus), Focal cortical dysplasia (abnormal collection of neurons), Brain tumors, Traumatic brain injury, Infections (brain abscess, meningitis, encephalitis), Vascular conditions (strokes, arteriovenous malformations), Genetic variants, Unknown causes.
- #2 Temporal Seizure – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK549852/
Temporal lobe epilepsy is the commonest seizure disorder and affects approximately fifty million people worldwide. […] The etiology of temporal lobe seizures is extensive. The most common causes are: Hippocampal sclerosis, Infections, Tumors, Traumatic brain injury, Vascular anomalies, Genetic, Cryptogenic. […] MTLE is the most common form of epilepsy and is most commonly due to a neurodegenerative process known as hippocampal sclerosis (HS) found in the majority of patients diagnosed with this condition, upon histological evaluation. […] Although about 10 to 15 percent of children who develop febrile seizures progress to a diagnosis of epilepsy, there is no compelling evidence of causality between a history of febrile seizures and the development of temporal lobe epilepsy. What is evident, however, is the association of lesions in anatomical correlates on neuroimaging, such as mesial temporal lobe sclerosis, in the pediatric population, and the development of temporal lobe epilepsy.
- #3 Temporal Lobe Epilepsy: Causes, Symptoms, and Treatmenthttps://www.healthline.com/health/temporal-lobe-epilepsy
Of all types of epilepsy, temporal lobe epilepsy is most common. It affects about 60 percent of all people with epilepsy and can occur at any age. There are many potential causes, and often the exact cause is unknown. […] Experts say some possible causes of temporal lobe seizures include: severe traumatic brain injury, infections or a history of infections like meningitis or encephalitis, scarring (gliosis) in the hippocampus part of the temporal lobe, blood vessel deformities in the brain, stroke, brain tumors, genetics, abnormal electrical activity in the brain.
- #4 Temporal lobe epilepsy | Tidsskrift for Den norske legeforeninghttps://tidsskriftet.no/en/2023/01/clinical-review/temporal-lobe-epilepsy
The temporal lobes are the part of the brain most likely to give rise to epileptic seizures. […] The temporal lobes are the most epileptogenic area of the brain, primarily because they are frequently the site of seizure-causing insults, for example, hypoxia and head trauma. Other causes of epilepsy can include low-grade gliomas, arteriovenous malformations, cortical malformations, autoimmune or viral encephalitis, genetic abnormalities, and hippocampal sclerosis. […] The causes of hippocampal sclerosis have been the subject of intense debate for many years. In children, prolonged febrile seizures have been shown to increase the risk of subsequent hippocampal sclerosis and epilepsy. Genetic vulnerability probably plays a role here. An association has been found, for example, between mutations in the SCN1A gene, prolonged febrile seizures, and hippocampal sclerosis. It is now generally accepted that hippocampal sclerosis can both cause and be caused by epileptic seizures.
- #5 What is Epilepsy? Types of Epilepsy and Seizure | MNChttps://miamineurosciencecenter.com/en/conditions/epilepsy/
Temporal lobe epilepsy (TLE) is epilepsy that originates in the temporal lobe of the brain. TLE accounts for 60 percent of all focal epilepsy. TLE causes focal (partial) seizures that may either impair awareness (called complex partial seizures) or slightly alter perception (called simple partial seizures) also referred to as auras. […] Some brain functions of the temporal lobe include emotions, memory, speech, and hearing. […] It is unlikely that medications alone will eliminate seizures, although medications can help control seizure frequency, duration, and intensity. […] There are two forms of TLE: Mesial temporal lobe epilepsy (MTLE) and Lateral temporal lobe epilepsy (LTLE). […] MTLE begins in the inner area of the temporal lobe such as the hippocampus. […] LTLE begins in the outer region of the temporal lobe.
- #6 Epilepsy – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: […] Other causes can be related to genetic abnormalities, prior brain infection, prenatal injuries or developmental disorders. But in about half of people with epilepsy, there’s no apparent cause. […] Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent. […] Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. […] Brain tumors can cause epilepsy. Epilepsy also may be caused by the way blood vessels form in the brain. People with blood vessel conditions such as arteriovenous malformations and cavernous malformations can have seizures. And in adults older than age 35, stroke is a leading cause of epilepsy.
- #7 Temporal lobe seizure | Altru Health Systemhttps://www.altru.org/health-library/conditions/temporal-lobe-seizure
Temporal lobe seizures begin in the temporal lobes of the brain. […] The cause of temporal lobe seizures often isn’t known. But it may stem from a scar in the temporal lobe. […] Often, experts don’t know the cause of temporal lobe seizures. But they can be a result of the following factors: Traumatic brain injury, infections such as encephalitis and meningitis, or a history of such infections, a process that causes scarring in a part of the temporal lobes called the hippocampus, known as gliosis, blood vessels in the brain that aren’t formed correctly, called vascular malformations, stroke, brain tumors, genetic syndromes, withdrawal from alcohol overuse. […] A burst of electrical activity in many brain cells may cause a seizure. […] If this burst happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that starts in one of the temporal lobes.
- #8 TLE Causes | Ohio State Medical Centerhttps://wexnermedical.osu.edu/brain-spine-neuro/epilepsy/temporal-lobe/causes
Like others with epilepsy, you didnt cause your condition of temporal lobe epilepsy (TLE). […] Almost 25% of all temporal lobe seizures are due to unknown causes. […] Sometimes TLE is the result of scarring in the temporal lobe following brain injury, a severe blow to the head or brain abnormalities that people are born with. […] Its also possible for TLE to develop following a brain infection, such as meningitis or encephalitis, as well as from brain vessel abnormalities, such as arteriovenous malformations or brain conditions like tumors, strokes or dementia. […] Although theres more research needed, genetic mutations or a family history of TLE may also play a role.
- #9 Temporal Lobe Epilepsy: Practice Essentials, Background, Etiologyhttps://emedicine.medscape.com/article/1184509-overview
Approximately two thirds of patients with temporal lobe epilepsy treated surgically have hippocampal sclerosis as the pathologic substrate. […] The etiologies of temporal lobe epilepsy include the following: Infections, eg, herpes encephalitis, bacterial meningitis, neurocysticercosis […] Trauma producing contusion or hemorrhage that results in encephalomalacia or cortical scarring; difficult, traumatic delivery such as forceps deliveries […] Hamartomas […] Malignancies (eg, meningiomas, gliomas, gangliomas) […] Paraneoplastic (anti-Hu , NMDA-receptor antibodies) […] Vascular malformations (ie, arteriovenous malformation, cavernous angioma) […] Cryptogenic (a cause is presumed but has not been identified) […] Idiopathic (genetic) […] A subset of children with complex febrile convulsions appears to be at risk of developing temporal lobe epilepsy in later life. […] The association of simple febrile seizure with temporal lobe epilepsy has been controversial.
- #10 Temporal lobe epilepsy | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/temporal-lobe-epilepsy?lang=us
Temporal lobe epilepsy may be due to a veritable menagerie of causes including 1-3: […] mesial temporal sclerosis (MTS): ~70% […] temporal lobe tumors: ~10% […] cortical dysplasia: 5-10% […] vascular malformations: ~5% […] trauma […] infection […] congenital […] temporal pole encephalocele (rare) 4.
- #11 Mesial Temporal Lobe Epilepsy – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK554432/
Most cases of MTLE are sporadic in occurrence, although familial forms are not uncommon. […] One study showed that as high as one-fifth of the newly diagnosed non-lesional MTLE could have a familial attribute. […] Research has identified a genetic locus for familial MTLE in a large family with autosomal dominant MTLE phenotype. […] The familial MTLE cases have been shown to exhibit a complex inheritance pattern and usually do not exhibit mesial temporal sclerosis on imaging. […] Hippocampal sclerosis (HS) is the most common histopathological abnormality found in patients with drug-resistant TLE. […] Other less common etiologies include post-infectious (most commonly after HSV encephalitis), vascular malformations, ischemic lesions, inflammatory lesions, and old traumatic encephalomalacia.
- #12 AIC News Release Temporal Lobe Epilepsyhttp://www.aiclancaster.com/Referring%20Doctors/Newsletters/nr_020103.htm
The most common cause of complex partial seizures is mesial temporal sclerosis (MTS), occurring in 35 to 65 percent of patients who undergo temporal lobe surgery. […] The cause of the neuronal loss is not known but may be related to repeated seizure activity (which places such high metabolic demands on neurons and eventually their destruction). […] Febrile seizures are also believed to be a potential cause of MTS. […] In addition to MTS, other temporal lobe lesions can cause seizures, including benign and malignant neoplasms, cortical dysplasia, vascular malformations and post-traumatic brain injury.
- #13 Temporal lobe epilepsieshttps://www.aboutkidshealth.ca/temporal-lobe-epilepsies
Temporal lobe epilepsy involves seizures that can produce a variety of sensations such as abdominal pain, fear or a sense of dj vu or jamais vu. […] It can be caused by a build-up of scar tissue on the temporal lobe, a tumour, a tangle of blood vessels or a temporal lobe malformation. Rarely, it is due to a genetic predisposition. […] Temporal lobe epilepsy is commonly caused by something called mesial temporal sclerosis. Mesial temporal sclerosis is a condition in which the mesial temporal region, the hippocampus, the amygdala and the uncus shrink and develop scar tissue, often with changes in the shape of the surrounding neurons. The cause is not clear. It is possible that prolonged febrile seizures in early childhood or continuing seizures contribute to the damage. Mesial temporal sclerosis is also called hippocampal sclerosis.
- #14 AIC News Release Temporal Lobe Epilepsyhttp://www.aiclancaster.com/Referring%20Doctors/Newsletters/nr_020103.htm
The most common cause of complex partial seizures is mesial temporal sclerosis (MTS), occurring in 35 to 65 percent of patients who undergo temporal lobe surgery. […] The cause of the neuronal loss is not known but may be related to repeated seizure activity (which places such high metabolic demands on neurons and eventually their destruction). […] Febrile seizures are also believed to be a potential cause of MTS. […] In addition to MTS, other temporal lobe lesions can cause seizures, including benign and malignant neoplasms, cortical dysplasia, vascular malformations and post-traumatic brain injury.
- #15 Temporal lobe epilepsy | Tidsskrift for Den norske legeforeninghttps://tidsskriftet.no/en/2023/01/clinical-review/temporal-lobe-epilepsy
The temporal lobes are the part of the brain most likely to give rise to epileptic seizures. […] The temporal lobes are the most epileptogenic area of the brain, primarily because they are frequently the site of seizure-causing insults, for example, hypoxia and head trauma. Other causes of epilepsy can include low-grade gliomas, arteriovenous malformations, cortical malformations, autoimmune or viral encephalitis, genetic abnormalities, and hippocampal sclerosis. […] The causes of hippocampal sclerosis have been the subject of intense debate for many years. In children, prolonged febrile seizures have been shown to increase the risk of subsequent hippocampal sclerosis and epilepsy. Genetic vulnerability probably plays a role here. An association has been found, for example, between mutations in the SCN1A gene, prolonged febrile seizures, and hippocampal sclerosis. It is now generally accepted that hippocampal sclerosis can both cause and be caused by epileptic seizures.
- #16 Temporal Seizure – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK549852/
Temporal lobe epilepsy is the commonest seizure disorder and affects approximately fifty million people worldwide. […] The etiology of temporal lobe seizures is extensive. The most common causes are: Hippocampal sclerosis, Infections, Tumors, Traumatic brain injury, Vascular anomalies, Genetic, Cryptogenic. […] MTLE is the most common form of epilepsy and is most commonly due to a neurodegenerative process known as hippocampal sclerosis (HS) found in the majority of patients diagnosed with this condition, upon histological evaluation. […] Although about 10 to 15 percent of children who develop febrile seizures progress to a diagnosis of epilepsy, there is no compelling evidence of causality between a history of febrile seizures and the development of temporal lobe epilepsy. What is evident, however, is the association of lesions in anatomical correlates on neuroimaging, such as mesial temporal lobe sclerosis, in the pediatric population, and the development of temporal lobe epilepsy.
- #17 Temporal lobe epilepsy: Symptoms, causes, and morehttps://www.medicalnewstoday.com/articles/temporal-lobe-epilepsy
Potential causes of TLE include febrile seizures and some types of brain injury, but, often, the causes remain unknown. […] There are several potential causes of TLE, though often the cause is unknown. Most of the time, TLE starts when a person is aged 10-20 years, but it can occur at any age. […] Some possible causes of TLE include: febrile seizures, brain injury at a young age, head trauma, brain infections, including encephalitis or meningitis, structural changes in the temporal lobe, including the hippocampus, genetics. […] A childhood febrile seizure is the most common risk factor, especially if the seizure was severe. […] Some common risk factors for TLE include: infections, including encephalitis or meningitis, at a young age, brain injury, injury during birth, structural changes in the temporal lobe, including brain malformations or tumors, head trauma involving a loss of consciousness. […] The cause of a TLE seizure is often unknown.
- #18 Temporal Lobe Epilepsy (for Parents) | Nemours KidsHealthhttps://kidshealth.org/en/parents/temporal-lobe-epilepsy.html
Infections, brain injury, a tumor, genetic mutations, or changes in brain structure all can cause temporal lobe epilepsy. […] Babies who have a febrile seizure (caused by a high fever) that lasts for 15 minutes or longer have a higher risk for developing the condition later on.
- #19 Temporal Lobe Epilepsy: Practice Essentials, Background, Etiologyhttps://emedicine.medscape.com/article/1184509-overview
Approximately two thirds of patients with temporal lobe epilepsy treated surgically have hippocampal sclerosis as the pathologic substrate. […] The etiologies of temporal lobe epilepsy include the following: Infections, eg, herpes encephalitis, bacterial meningitis, neurocysticercosis […] Trauma producing contusion or hemorrhage that results in encephalomalacia or cortical scarring; difficult, traumatic delivery such as forceps deliveries […] Hamartomas […] Malignancies (eg, meningiomas, gliomas, gangliomas) […] Paraneoplastic (anti-Hu , NMDA-receptor antibodies) […] Vascular malformations (ie, arteriovenous malformation, cavernous angioma) […] Cryptogenic (a cause is presumed but has not been identified) […] Idiopathic (genetic) […] A subset of children with complex febrile convulsions appears to be at risk of developing temporal lobe epilepsy in later life. […] The association of simple febrile seizure with temporal lobe epilepsy has been controversial.
- #20 Temporal lobe seizure | Altru Health Systemhttps://www.altru.org/health-library/conditions/temporal-lobe-seizure
Temporal lobe seizures begin in the temporal lobes of the brain. […] The cause of temporal lobe seizures often isn’t known. But it may stem from a scar in the temporal lobe. […] Often, experts don’t know the cause of temporal lobe seizures. But they can be a result of the following factors: Traumatic brain injury, infections such as encephalitis and meningitis, or a history of such infections, a process that causes scarring in a part of the temporal lobes called the hippocampus, known as gliosis, blood vessels in the brain that aren’t formed correctly, called vascular malformations, stroke, brain tumors, genetic syndromes, withdrawal from alcohol overuse. […] A burst of electrical activity in many brain cells may cause a seizure. […] If this burst happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that starts in one of the temporal lobes.
- #21 Epilepsy in Adults (Causes, Symptoms, and Treatment)https://patient.info/doctor/epilepsy-in-adults
Most are idiopathic; seizures due to underlying diseases affecting the brain are more likely to have a focal onset. […] Cerebrovascular disease such as cerebral infarction, cerebral haemorrhage and venous thrombosis. […] Head injury: head trauma is more significant when it occurs with loss of consciousness lasting longer than 30 minutes, post-traumatic amnesia lasting longer than 30 minutes, focal neurological findings or neuro-imaging findings suggesting a structural brain injury. […] Following cranial surgery. […] CNS infections such as meningitis or encephalitis. […] Neurodegenerative diseases: epilepsy is more common in people with Alzheimer’s disease or multi-infarct dementia. […] Autoimmune disease. […] Brain neoplasm. […] Genetic diseases. […] Drugs: for example, phenothiazines, isoniazid, tricyclic antidepressants; drug withdrawal (eg, benzodiazepines). […] Alcohol misuse: including alcohol withdrawal, binge alcohol drinking. […] Metabolic medical disorders such as renal failure, hypoglycaemia, hyponatraemia, hypernatraemia, hypercalcaemia and hypocalcaemia.
- #22 Temporal lobe epilepsy – Wikipediahttps://en.wikipedia.org/wiki/Temporal_lobe_epilepsy
In the field of neurology, temporal lobe epilepsy is an enduring brain disorder that causes unprovoked seizures from the temporal lobe. […] Temporal lobe epilepsy occurs from seizures arising within the temporal lobe. […] These types of TLE are very rare due to the genetic cause or lesions such as tumor, birth defect, or blood vessel abnormalities in the temporal lobe. […] Hippocampal sclerosis, brain tumor, traumatic brain injury, cerebral vascular malformation, neuronal migration disorders, infections such as encephalitis and meningitis, autoimmune disease (limbic encephalitis), and genetic disorders may cause temporal lobe epilepsy. […] Many persons with uncontrolled temporal lobe epilepsy had childhood febrile seizures. […] Those who experienced any sort of brain injury in their early life have a higher risk of developing epilepsy.
- #23 Temporal Lobe Seizures: Causes, Symptoms & Treatmenthttps://manhattanmedicalarts.com/conditions-symptoms/temporal-tobe-seizures
Temporal lobe seizures, a type of epilepsy, can be caused by several reasons. Epilepsy, a neurological illness characterized by recurring, unprovoked seizures, is the most common cause of temporal lobe seizures. A complicated interaction of hereditary factors, head injuries, or structural abnormalities in the brain can cause epilepsy. […] These structural anomalies, which can be hereditary or acquired through time, might trigger temporal lobe seizures. Brain abnormalities, such as tumors, strokes, or traumas, can potentially play a role in the progression of this disorder. […] Because of their nature, these lesions can irritate or damage the fragile structures within the temporal lobes, resulting in seizure activity. Infections, such as encephalitis, can also pose a severe risk. This inflammatory disorder that affects the brain can cause seizures by affecting the temporal lobes.
- #24 Temporal Lobe Epilepsy: Practice Essentials, Background, Etiologyhttps://emedicine.medscape.com/article/1184509-overview
Approximately two thirds of patients with temporal lobe epilepsy treated surgically have hippocampal sclerosis as the pathologic substrate. […] The etiologies of temporal lobe epilepsy include the following: Infections, eg, herpes encephalitis, bacterial meningitis, neurocysticercosis […] Trauma producing contusion or hemorrhage that results in encephalomalacia or cortical scarring; difficult, traumatic delivery such as forceps deliveries […] Hamartomas […] Malignancies (eg, meningiomas, gliomas, gangliomas) […] Paraneoplastic (anti-Hu , NMDA-receptor antibodies) […] Vascular malformations (ie, arteriovenous malformation, cavernous angioma) […] Cryptogenic (a cause is presumed but has not been identified) […] Idiopathic (genetic) […] A subset of children with complex febrile convulsions appears to be at risk of developing temporal lobe epilepsy in later life. […] The association of simple febrile seizure with temporal lobe epilepsy has been controversial.
- #25 Temporal lobe epilepsy: Symptoms, causes, and morehttps://www.medicalnewstoday.com/articles/temporal-lobe-epilepsy
Potential causes of TLE include febrile seizures and some types of brain injury, but, often, the causes remain unknown. […] There are several potential causes of TLE, though often the cause is unknown. Most of the time, TLE starts when a person is aged 10-20 years, but it can occur at any age. […] Some possible causes of TLE include: febrile seizures, brain injury at a young age, head trauma, brain infections, including encephalitis or meningitis, structural changes in the temporal lobe, including the hippocampus, genetics. […] A childhood febrile seizure is the most common risk factor, especially if the seizure was severe. […] Some common risk factors for TLE include: infections, including encephalitis or meningitis, at a young age, brain injury, injury during birth, structural changes in the temporal lobe, including brain malformations or tumors, head trauma involving a loss of consciousness. […] The cause of a TLE seizure is often unknown.
- #26 Epilepsy – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
Meningitis, HIV, viral encephalitis and some parasitic infections can cause epilepsy. […] Before they’re born, babies are sensitive to brain damage that could be caused by several factors. They might include an infection in the mother, poor nutrition or not enough oxygen. This brain damage can result in epilepsy or cerebral palsy. […] Epilepsy can sometimes occur with developmental conditions. People with autism are more likely to have epilepsy than are people without autism. Research also has found that people with epilepsy are more likely to have attention-deficit/hyperactivity disorder (ADHD) and other developmental conditions. Having both conditions may be related to genes.
- #27 Temporal Lobe Lesions: Causes, Symptoms, and Treatmenthttps://patient.info/brain-nerves/temporal-lobe-lesions-leaflet
The temporal lobe can be affected by various conditions, particularly a stroke, brain tumour or head injury. […] There are many possible causes of temporal lobe lesions. The most common causes include: A stroke. A stroke usually affects other parts of the brain but may occur in the temporal lobe. […] Brain tumours may also affect the temporal lobe of the brain. […] A serious head injury or a surgical operation to remove a brain tumour may may also cause damage to the temporal lobe. […] The temporal lobe can be affected by an infection of the brain (encephalitis), especially encephalitis due to herpes simplex virus. […] Other conditions affecting the brain, such as multiple sclerosis, can also affect the temporal lobes of the brain.
- #28 Human herpesvirus-6B implicated in the etiology of mesial temporal lobe epilepsy | Nature Reviews Neurologyhttps://www.nature.com/articles/ncpneuro0571
Mesial temporal lobe epilepsy (MTLE) is a common and intractable form of seizure disorder that is characterized by extensive hippocampal scarring and is associated with a childhood history of prolonged febrile seizures. Human herpesvirus-6B (HHV-6B) is a -herpesvirus known to cause febrile seizures in young children, and high viral loads of HHV-6B have been documented in brain tissue resected from patients with MTLE. […] Now, an international group of researchers report compelling evidence that HHV-6B infection might have a role in the etiology of MTLE.
- #29 Mesial Temporal Lobe Epilepsy – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK554432/
Most cases of MTLE are sporadic in occurrence, although familial forms are not uncommon. […] One study showed that as high as one-fifth of the newly diagnosed non-lesional MTLE could have a familial attribute. […] Research has identified a genetic locus for familial MTLE in a large family with autosomal dominant MTLE phenotype. […] The familial MTLE cases have been shown to exhibit a complex inheritance pattern and usually do not exhibit mesial temporal sclerosis on imaging. […] Hippocampal sclerosis (HS) is the most common histopathological abnormality found in patients with drug-resistant TLE. […] Other less common etiologies include post-infectious (most commonly after HSV encephalitis), vascular malformations, ischemic lesions, inflammatory lesions, and old traumatic encephalomalacia.
- #30 Temporal Lobe Epilepsy (TLE): Causes, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/17778-temporal-lobe-seizures
Temporal lobe epilepsy is a seizure-causing condition that starts in your temporal lobe. […] Temporal lobe epilepsy (TLE) is a type of epilepsy where seizures begin in the temporal lobe. Seizures are the result of abnormal electrical activity in your brain. […] Neurons (nerve cells) miscommunicating in your temporal lobe cause temporal lobe epilepsy. Neurons send electrical signals to different parts of your brain. When a seizure happens, neurons uncontrollably fire off signals instead of directing them to where they need to go. […] Some of the most common causes of temporal lobe epilepsy include: Hippocampal sclerosis (neuron and glial cell loss in the hippocampus), Focal cortical dysplasia (abnormal collection of neurons), Brain tumors, Traumatic brain injury, Infections (brain abscess, meningitis, encephalitis), Vascular conditions (strokes, arteriovenous malformations), Genetic variants, Unknown causes.
- #31 Temporal lobe seizure // Middlesex Healthhttps://middlesexhealth.org/learning-center/diseases-and-conditions/temporal-lobe-seizure
Temporal lobe seizures begin in the temporal lobes of the brain. […] The cause of temporal lobe seizures often isn’t known. But it may stem from a scar in the temporal lobe. […] Often, experts don’t know the cause of temporal lobe seizures. But they can be a result of the following factors: […] A process that causes scarring in a part of the temporal lobes called the hippocampus. This is known as gliosis. […] Blood vessels in the brain that aren’t formed correctly, called vascular malformations. […] Stroke. […] Brain tumors. […] Genetic syndromes. […] Withdrawal from alcohol overuse. […] A burst of electrical activity in many brain cells may cause a seizure. […] If this burst happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that starts in one of the temporal lobes.
- #32 Epilepsy – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: […] Other causes can be related to genetic abnormalities, prior brain infection, prenatal injuries or developmental disorders. But in about half of people with epilepsy, there’s no apparent cause. […] Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent. […] Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. […] Brain tumors can cause epilepsy. Epilepsy also may be caused by the way blood vessels form in the brain. People with blood vessel conditions such as arteriovenous malformations and cavernous malformations can have seizures. And in adults older than age 35, stroke is a leading cause of epilepsy.
- #33 Temporal lobe epilepsy | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/temporal-lobe-epilepsy?lang=us
Temporal lobe epilepsy may be due to a veritable menagerie of causes including 1-3: […] mesial temporal sclerosis (MTS): ~70% […] temporal lobe tumors: ~10% […] cortical dysplasia: 5-10% […] vascular malformations: ~5% […] trauma […] infection […] congenital […] temporal pole encephalocele (rare) 4.
- #34 Epilepsy – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: […] Other causes can be related to genetic abnormalities, prior brain infection, prenatal injuries or developmental disorders. But in about half of people with epilepsy, there’s no apparent cause. […] Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent. […] Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. […] Brain tumors can cause epilepsy. Epilepsy also may be caused by the way blood vessels form in the brain. People with blood vessel conditions such as arteriovenous malformations and cavernous malformations can have seizures. And in adults older than age 35, stroke is a leading cause of epilepsy.
- #35 Temporal Lobe Epilepsy: Practice Essentials, Background, Etiologyhttps://emedicine.medscape.com/article/1184509-overview
Approximately two thirds of patients with temporal lobe epilepsy treated surgically have hippocampal sclerosis as the pathologic substrate. […] The etiologies of temporal lobe epilepsy include the following: Infections, eg, herpes encephalitis, bacterial meningitis, neurocysticercosis […] Trauma producing contusion or hemorrhage that results in encephalomalacia or cortical scarring; difficult, traumatic delivery such as forceps deliveries […] Hamartomas […] Malignancies (eg, meningiomas, gliomas, gangliomas) […] Paraneoplastic (anti-Hu , NMDA-receptor antibodies) […] Vascular malformations (ie, arteriovenous malformation, cavernous angioma) […] Cryptogenic (a cause is presumed but has not been identified) […] Idiopathic (genetic) […] A subset of children with complex febrile convulsions appears to be at risk of developing temporal lobe epilepsy in later life. […] The association of simple febrile seizure with temporal lobe epilepsy has been controversial.
- #36 Temporal lobe epilepsy | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/temporal-lobe-epilepsy?lang=us
Temporal lobe epilepsy may be due to a veritable menagerie of causes including 1-3: […] mesial temporal sclerosis (MTS): ~70% […] temporal lobe tumors: ~10% […] cortical dysplasia: 5-10% […] vascular malformations: ~5% […] trauma […] infection […] congenital […] temporal pole encephalocele (rare) 4.
- #37 Temporal Lobe Epilepsy: Pathologic Substrates and Causes â Nova Science Publishershttps://novapublishers.com/shop/temporal-lobe-epilepsy-pathologic-substrates-and-causes/
Pharmacoresistent or medically intractable epilepsy remains a challenge for those who are involved with the care of patients who suffer from this problem. Many of these patients have epilepsy originating in the temporal lobe. […] Among the topics that will specifically be examined in this text are the more commonly encountered etiologies including hippocampal sclerosis, the focal cortical dysplasias as well as other developmental anomalies, glioneuronal tumors and vascular lesions.
- #38 Epilepsy – Neurosurgery | UCLA Healthhttps://www.uclahealth.org/medical-services/neurosurgery/conditions-treated/epilepsy
Epilepsy is a general term covering a variety of conditions in which seizures occur. […] Some causes of seizures include brain damage due to trauma, tumors or other brain lesions, abnormal development of the brain in early childhood, and a family history of epilepsy. […] Epilepsy may mean the patient is harboring a brain tumor or vascular malformation. A magnetic resonance imaging (MRI) study is recommended early on the management of epilepsy so that surgery can be performed as soon as possible if such a lesion is present. […] The location and type of damage or malformation in the brain determines the recommended epilepsy surgery option and play a critical role in treatment outcomes. […] UCLA holds a 70 percent success rate for temporal lobe surgery, and 25 percent have noticeably fewer seizures.
- #39 Temporal lobe epilepsy | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/temporal-lobe-epilepsy?lang=us
Temporal lobe epilepsy may be due to a veritable menagerie of causes including 1-3: […] mesial temporal sclerosis (MTS): ~70% […] temporal lobe tumors: ~10% […] cortical dysplasia: 5-10% […] vascular malformations: ~5% […] trauma […] infection […] congenital […] temporal pole encephalocele (rare) 4.
- #40 Temporal Lobe Epilepsy (TLE): Causes, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/17778-temporal-lobe-seizures
Temporal lobe epilepsy is a seizure-causing condition that starts in your temporal lobe. […] Temporal lobe epilepsy (TLE) is a type of epilepsy where seizures begin in the temporal lobe. Seizures are the result of abnormal electrical activity in your brain. […] Neurons (nerve cells) miscommunicating in your temporal lobe cause temporal lobe epilepsy. Neurons send electrical signals to different parts of your brain. When a seizure happens, neurons uncontrollably fire off signals instead of directing them to where they need to go. […] Some of the most common causes of temporal lobe epilepsy include: Hippocampal sclerosis (neuron and glial cell loss in the hippocampus), Focal cortical dysplasia (abnormal collection of neurons), Brain tumors, Traumatic brain injury, Infections (brain abscess, meningitis, encephalitis), Vascular conditions (strokes, arteriovenous malformations), Genetic variants, Unknown causes.
- #41 Temporal Lobe Epilepsy â Pathophysiology and Mechanisms – touchNEUROLOGYhttps://touchneurology.com/epilepsy/journal-articles/temporal-lobe-epilepsy-pathophysiology-and-mechanisms/
Granule cell dispersion (GCD) in the dentate gyrus is observed in HS, which may be a consequence of enhanced proliferation of granule cell precursors as a result of seizures. […] Malformations of cortical development (MCD) represent abnormalities in the development of the cortex which involves processes such as regionalisation, cell proliferation, neuronal migration and cortical organisation. […] Focal cortical dysplasia (FCD) is a subtype of MCD which causes chronic medically refractory epilepsy in the paediatric population, and is a frequent cause of epilepsy in adults. […] TSC2 mutation causes hyperexcitability of glutamate-mediated neurons which will lead to seizures.
- #42 Temporal Lobe Epilepsy â Pathophysiology and Mechanisms – touchNEUROLOGYhttps://touchneurology.com/epilepsy/journal-articles/temporal-lobe-epilepsy-pathophysiology-and-mechanisms/
Granule cell dispersion (GCD) in the dentate gyrus is observed in HS, which may be a consequence of enhanced proliferation of granule cell precursors as a result of seizures. […] Malformations of cortical development (MCD) represent abnormalities in the development of the cortex which involves processes such as regionalisation, cell proliferation, neuronal migration and cortical organisation. […] Focal cortical dysplasia (FCD) is a subtype of MCD which causes chronic medically refractory epilepsy in the paediatric population, and is a frequent cause of epilepsy in adults. […] TSC2 mutation causes hyperexcitability of glutamate-mediated neurons which will lead to seizures.
- #43 Mesial Temporal Lobe Epilepsy – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK554432/
Most cases of MTLE are sporadic in occurrence, although familial forms are not uncommon. […] One study showed that as high as one-fifth of the newly diagnosed non-lesional MTLE could have a familial attribute. […] Research has identified a genetic locus for familial MTLE in a large family with autosomal dominant MTLE phenotype. […] The familial MTLE cases have been shown to exhibit a complex inheritance pattern and usually do not exhibit mesial temporal sclerosis on imaging. […] Hippocampal sclerosis (HS) is the most common histopathological abnormality found in patients with drug-resistant TLE. […] Other less common etiologies include post-infectious (most commonly after HSV encephalitis), vascular malformations, ischemic lesions, inflammatory lesions, and old traumatic encephalomalacia.
- #44 Autosomal dominant epilepsy with auditory features: MedlinePlus GeneticsLockhttps://medlineplus.gov/genetics/condition/autosomal-dominant-epilepsy-with-auditory-features/
Autosomal dominant epilepsy with auditory features (ADEAF) is an uncommon form of epilepsy that runs in families. […] ADEAF is called a focal epilepsy because the seizures start in one part of the brain, rather than involving the entire brain from the beginning. […] Most people with ADEAF have focal aware seizures, which do not cause a loss of consciousness. […] These seizures are thought to begin in a part of the brain called the lateral temporal lobe. […] Variants (also called mutations) in the LGI1 gene or RELN gene are the most common cause of ADEAF. […] Variants in other genes have been identified in small numbers of affected families, and the genetic cause in many families is unknown. […] Variants in the LGI1 or RELN gene may impair the formation or function of synapses. […] Abnormal communication between neurons can lead to seizure activity in the brain.
- #45 Temporal Lobe Epilepsy â Pathophysiology and Mechanisms – touchNEUROLOGYhttps://touchneurology.com/epilepsy/journal-articles/temporal-lobe-epilepsy-pathophysiology-and-mechanisms/
Temporal lobe epilepsy (TLE) is a disorder of the nervous system due to unprovoked seizures originating from the temporal lobe. The main cause of TLE is neuronal hyperexcitability due to the presence of pathological changes in the temporal lobe of the brain such as neuronal loss, mutation, granule cell dispersion and malformations of cortical development. […] The factors that cause this alteration in the balance of excitation and inhibition can be genetic or acquired. […] Mutation of the neuron-specific type 2 K+/Cl cotransporter (KCC2) in some of the subicular pyramidal cells, which leads to loss of function, is one of the causes of HS-associated MTLE. […] An increase in intracellular Cl concentration causes efflux of Cl through GABA receptors, resulting in depolarisation and hyperexcitability, and subsequently leading to seizures.
- #46 Temporal Lobe Epilepsy: Symptoms, Causes, and Treatment | MyEpilepsyTeamhttps://www.myepilepsyteam.com/resources/temporal-lobe-epilepsy-symptoms-causes-and-treatment
Temporal lobe epilepsy, or TLE, is the most common type of focal epilepsy. […] While the cause of many cases of TLE is unknown, there are some known risk factors. Brain injuries (such as head trauma), infections of the central nervous system, or abnormalities of temporal lobe structures can cause this type of epilepsy. This includes a type of scarring in the temporal lobe called mesial temporal sclerosis, or hippocampal sclerosis. […] TLE is also very frequently associated with a history of febrile seizures. Febrile seizures can happen when children have a high fever. […] There may also be a genetic basis or predisposition to TLE in some people. There is only one gene that has been repeatedly shown to have an association with TLE the LGI1 gene. This gene tells the brain how to make a protein called leucine-rich glioma inactivated 1, or epitempin. This protein plays a critical role in the regulation of the potassium channels that help control cell-to-cell communication in the brain. Future research may shed light on other underlying genetic factors.
- #47 Mesial Temporal Lobe Epilepsy – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK554432/
Most cases of MTLE are sporadic in occurrence, although familial forms are not uncommon. […] One study showed that as high as one-fifth of the newly diagnosed non-lesional MTLE could have a familial attribute. […] Research has identified a genetic locus for familial MTLE in a large family with autosomal dominant MTLE phenotype. […] The familial MTLE cases have been shown to exhibit a complex inheritance pattern and usually do not exhibit mesial temporal sclerosis on imaging. […] Hippocampal sclerosis (HS) is the most common histopathological abnormality found in patients with drug-resistant TLE. […] Other less common etiologies include post-infectious (most commonly after HSV encephalitis), vascular malformations, ischemic lesions, inflammatory lesions, and old traumatic encephalomalacia.
- #48 Temporal Lobe Epilepsy: Symptoms, Causes, and Treatment | MyEpilepsyTeamhttps://www.myepilepsyteam.com/resources/temporal-lobe-epilepsy-symptoms-causes-and-treatment
Temporal lobe epilepsy, or TLE, is the most common type of focal epilepsy. […] While the cause of many cases of TLE is unknown, there are some known risk factors. Brain injuries (such as head trauma), infections of the central nervous system, or abnormalities of temporal lobe structures can cause this type of epilepsy. This includes a type of scarring in the temporal lobe called mesial temporal sclerosis, or hippocampal sclerosis. […] TLE is also very frequently associated with a history of febrile seizures. Febrile seizures can happen when children have a high fever. […] There may also be a genetic basis or predisposition to TLE in some people. There is only one gene that has been repeatedly shown to have an association with TLE the LGI1 gene. This gene tells the brain how to make a protein called leucine-rich glioma inactivated 1, or epitempin. This protein plays a critical role in the regulation of the potassium channels that help control cell-to-cell communication in the brain. Future research may shed light on other underlying genetic factors.
- #49 Autosomal dominant epilepsy with auditory features: MedlinePlus GeneticsLockhttps://medlineplus.gov/genetics/condition/autosomal-dominant-epilepsy-with-auditory-features/
Autosomal dominant epilepsy with auditory features (ADEAF) is an uncommon form of epilepsy that runs in families. […] ADEAF is called a focal epilepsy because the seizures start in one part of the brain, rather than involving the entire brain from the beginning. […] Most people with ADEAF have focal aware seizures, which do not cause a loss of consciousness. […] These seizures are thought to begin in a part of the brain called the lateral temporal lobe. […] Variants (also called mutations) in the LGI1 gene or RELN gene are the most common cause of ADEAF. […] Variants in other genes have been identified in small numbers of affected families, and the genetic cause in many families is unknown. […] Variants in the LGI1 or RELN gene may impair the formation or function of synapses. […] Abnormal communication between neurons can lead to seizure activity in the brain.
- #50 Temporal lobe epilepsy – Wikipediahttps://en.wikipedia.org/wiki/Temporal_lobe_epilepsy
In the field of neurology, temporal lobe epilepsy is an enduring brain disorder that causes unprovoked seizures from the temporal lobe. […] Temporal lobe epilepsy occurs from seizures arising within the temporal lobe. […] These types of TLE are very rare due to the genetic cause or lesions such as tumor, birth defect, or blood vessel abnormalities in the temporal lobe. […] Hippocampal sclerosis, brain tumor, traumatic brain injury, cerebral vascular malformation, neuronal migration disorders, infections such as encephalitis and meningitis, autoimmune disease (limbic encephalitis), and genetic disorders may cause temporal lobe epilepsy. […] Many persons with uncontrolled temporal lobe epilepsy had childhood febrile seizures. […] Those who experienced any sort of brain injury in their early life have a higher risk of developing epilepsy.
- #51 Temporal Lobe Epilepsy: Practice Essentials, Background, Etiologyhttps://emedicine.medscape.com/article/1184509-overview
Approximately two thirds of patients with temporal lobe epilepsy treated surgically have hippocampal sclerosis as the pathologic substrate. […] The etiologies of temporal lobe epilepsy include the following: Infections, eg, herpes encephalitis, bacterial meningitis, neurocysticercosis […] Trauma producing contusion or hemorrhage that results in encephalomalacia or cortical scarring; difficult, traumatic delivery such as forceps deliveries […] Hamartomas […] Malignancies (eg, meningiomas, gliomas, gangliomas) […] Paraneoplastic (anti-Hu , NMDA-receptor antibodies) […] Vascular malformations (ie, arteriovenous malformation, cavernous angioma) […] Cryptogenic (a cause is presumed but has not been identified) […] Idiopathic (genetic) […] A subset of children with complex febrile convulsions appears to be at risk of developing temporal lobe epilepsy in later life. […] The association of simple febrile seizure with temporal lobe epilepsy has been controversial.
- #52 Seizure Disorders – Neurologic Disorders – MSD Manual Professional Editionhttps://www.msdmanuals.com/professional/neurologic-disorders/seizure-disorders/seizure-disorders
Common causes of seizures vary by age of onset: […] Adults: Cerebral trauma, alcohol withdrawal, tumors, strokes, and an unknown cause (in 50%) […] In cryptogenic epilepsy and often in refractory epilepsy, a rare but increasingly identified cause is anti-NMDA receptor encephalitis, especially in young women. […] The seizures it causes are called symptomatic epileptic seizures. Such seizures are most common among neonates and older people. […] Epilepsy is often idiopathic, but various brain disorders, such as malformations, strokes, and tumors, can cause symptomatic epilepsy. […] In older people: Tumors and strokes. […] In reflex epilepsy, a rare disorder, seizures are triggered predictably by an external stimulus, such as repetitive sounds, flashing lights, video games, music, or even touching certain parts of the body.
- #53 Temporal Lobe Epilepsy: From Etiology to Treatment | Frontiers Research Topichttps://www.frontiersin.org/research-topics/20585/temporal-lobe-epilepsy-from-etiology-to-treatmentundefined
Temporal lobe epilepsy (TLE) represents the most common focal epilepsy syndrome in adulthood. […] Among the different etiologies, hippocampal sclerosis in adults and focal cortical dysplasia in children are the most common pathologies identified on magnetic resonance imaging (MRI), and have advanced and accurate diagnostic and therapeutic approaches. […] However, in around 20-30% of refractory patients with TLE, brain MRI does not demonstrate any epileptogenic lesion. The etiologies behind this non-lesional TLE is being clarified by the identification of new pathologies that do not leave a specific trace in brain MRI, or in which this trace is difficult to identify. […] Difficult to diagnose etiologies in TLE include some forms of autoimmune epilepsies, TLE with a genetic origin, and occult temporal pole encephaloceles, that might be considered both in controlled and refractory non-lesional TLE.
- #54 Temporal Lobe Epilepsy: From Etiology to Treatment | Frontiers Research Topichttps://www.frontiersin.org/research-topics/20585/temporal-lobe-epilepsy-from-etiology-to-treatmentundefined
Temporal lobe epilepsy (TLE) represents the most common focal epilepsy syndrome in adulthood. […] Among the different etiologies, hippocampal sclerosis in adults and focal cortical dysplasia in children are the most common pathologies identified on magnetic resonance imaging (MRI), and have advanced and accurate diagnostic and therapeutic approaches. […] However, in around 20-30% of refractory patients with TLE, brain MRI does not demonstrate any epileptogenic lesion. The etiologies behind this non-lesional TLE is being clarified by the identification of new pathologies that do not leave a specific trace in brain MRI, or in which this trace is difficult to identify. […] Difficult to diagnose etiologies in TLE include some forms of autoimmune epilepsies, TLE with a genetic origin, and occult temporal pole encephaloceles, that might be considered both in controlled and refractory non-lesional TLE.
- #55 Temporal lobe epilepsy with amygdala enlargement: a subtype of temporal lobe epilepsy | BMC Neurology | Full Texthttps://bmcneurol.biomedcentral.com/articles/10.1186/s12883-014-0194-z
Some recent studies suggest that some imaging-negative temporal lobe epilepsy (TLE) had significant amygdala enlargement (AE). […] Previous studies demonstrated significant amygdala enlargement (AE) was associated with dysphoric disorder and psychosis in TLE patients without hippocampal sclerosis (HS). […] A neurophysiological study using intracranial recordings showed that 5% of mesial TLE (MTLE) patients had seizure onset in the amygdala. […] Recently, some studies reported AE was observed in „magnetic resonance imaging (MRI) negative” TLE. […] The mechanisms leading to amygdala enlargement in TLE are a matter of debate. A recent study reported the chronic and long lasting inflammatory processes with or without a self-limited course occurred in these TLE patients could lead to amygdala enlargement possibly.
- #56 Temporal lobe seizure // Middlesex Healthhttps://middlesexhealth.org/learning-center/diseases-and-conditions/temporal-lobe-seizure
Temporal lobe seizures begin in the temporal lobes of the brain. […] The cause of temporal lobe seizures often isn’t known. But it may stem from a scar in the temporal lobe. […] Often, experts don’t know the cause of temporal lobe seizures. But they can be a result of the following factors: […] A process that causes scarring in a part of the temporal lobes called the hippocampus. This is known as gliosis. […] Blood vessels in the brain that aren’t formed correctly, called vascular malformations. […] Stroke. […] Brain tumors. […] Genetic syndromes. […] Withdrawal from alcohol overuse. […] A burst of electrical activity in many brain cells may cause a seizure. […] If this burst happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that starts in one of the temporal lobes.
- #57 Epilepsy in Adults (Causes, Symptoms, and Treatment)https://patient.info/doctor/epilepsy-in-adults
Most are idiopathic; seizures due to underlying diseases affecting the brain are more likely to have a focal onset. […] Cerebrovascular disease such as cerebral infarction, cerebral haemorrhage and venous thrombosis. […] Head injury: head trauma is more significant when it occurs with loss of consciousness lasting longer than 30 minutes, post-traumatic amnesia lasting longer than 30 minutes, focal neurological findings or neuro-imaging findings suggesting a structural brain injury. […] Following cranial surgery. […] CNS infections such as meningitis or encephalitis. […] Neurodegenerative diseases: epilepsy is more common in people with Alzheimer’s disease or multi-infarct dementia. […] Autoimmune disease. […] Brain neoplasm. […] Genetic diseases. […] Drugs: for example, phenothiazines, isoniazid, tricyclic antidepressants; drug withdrawal (eg, benzodiazepines). […] Alcohol misuse: including alcohol withdrawal, binge alcohol drinking. […] Metabolic medical disorders such as renal failure, hypoglycaemia, hyponatraemia, hypernatraemia, hypercalcaemia and hypocalcaemia.
- #58 What is Epilepsy? Types of Epilepsy and Seizure | MNChttps://miamineurosciencecenter.com/en/conditions/epilepsy/
Temporal lobe epilepsy (TLE) is epilepsy that originates in the temporal lobe of the brain. TLE accounts for 60 percent of all focal epilepsy. TLE causes focal (partial) seizures that may either impair awareness (called complex partial seizures) or slightly alter perception (called simple partial seizures) also referred to as auras. […] Some brain functions of the temporal lobe include emotions, memory, speech, and hearing. […] It is unlikely that medications alone will eliminate seizures, although medications can help control seizure frequency, duration, and intensity. […] There are two forms of TLE: Mesial temporal lobe epilepsy (MTLE) and Lateral temporal lobe epilepsy (LTLE). […] MTLE begins in the inner area of the temporal lobe such as the hippocampus. […] LTLE begins in the outer region of the temporal lobe.
- #59 TEMPORAL LOBE SEIZUREhttps://www.epilepsydiagnosis.org/seizure/temporal-overview.html
Seizures that arise in the mesial temporal lobe may be characterized by distinctive seizure onset features such as an autonomic seizure with rising epigastric sensation or abdominal discomfort, or cognitive seizure with deja vu/jamais vu, or emotional seizure with fear. Unpleasant olfactory and gustatory sensory seizures may also occur. […] Lateral temporal lobe seizures may have an initial focal seizure with auditory or vertiginous features. The focal sensory auditory seizure is usually a basic sound such as buzzing or ringing (rather than formed speech). If the sound is heard in only one ear it suggests the seizure is in the contralateral hemisphere.
- #60 Mesial Temporal Lobe Epilepsy | Texas Children’shttps://www.texaschildrens.org/content/conditions/mesial-temporal-lobe-epilepsy
Mesial temporal lobe epilepsy (MTLE) affects the inner part of the temporal lobe manifesting in the hippocampus, parahippocampal gyrus and the amygdala. […] The exact cause of MTLE is unknown, however it is often associated with a family history of epilepsy, prolonged febrile seizure, pediatric trauma or infection.
- #61 TLE⯠| Ohio State Medical Centerhttps://wexnermedical.osu.edu/brain-spine-neuro/epilepsy/temporal-lobe
Epilepsy is a complex disease, with different types of seizures that may start in different parts of the brain. […] The most common form of focal epilepsy is temporal lobe epilepsy. […] Youll be diagnosed with temporal lobe epilepsy (TLE) if this is where your seizures start. […] There are two types of TLE, which usually begin between the ages of 10 and 20, but can start at any age: […] Almost 80% of all temporal lobe seizures are due to MTLE.
- #62 Is it an epileptic seizure? | Medicina Universitariahttps://www.elsevier.es/en-revista-medicina-universitaria-304-articulo-is-it-an-epileptic-seizure-S1665579615000319
For example, a history of complicated febrile seizures is observed more commonly in patients with mesial temporal lobe epileptic seizures. […] In adults the most frequent etiologies are cerebrovascular disease, drug or alcohol suppression, brain injury and cerebral neoplasias. […] Non-provoked seizures are a result of chronic or functional structural alterations, which affect the neuronal cortical function and are denominated symptomatic. […] In adults, the most common causes are brain injury, cerebrovascular disease and cerebral neoplasias. […] Among the elderly, cerebrovascular disease is responsible for two-thirds of symptomatic seizures, followed by neurodegenerative alteration. […] In most cases the etiology can be unknown. […] When a structural injury or functional alteration is suspected but not proven, the epilepsy is classified as cryptogenic.
- #63 Seizure Disorders – Neurologic Disorders – MSD Manual Professional Editionhttps://www.msdmanuals.com/professional/neurologic-disorders/seizure-disorders/seizure-disorders
Common causes of seizures vary by age of onset: […] Adults: Cerebral trauma, alcohol withdrawal, tumors, strokes, and an unknown cause (in 50%) […] In cryptogenic epilepsy and often in refractory epilepsy, a rare but increasingly identified cause is anti-NMDA receptor encephalitis, especially in young women. […] The seizures it causes are called symptomatic epileptic seizures. Such seizures are most common among neonates and older people. […] Epilepsy is often idiopathic, but various brain disorders, such as malformations, strokes, and tumors, can cause symptomatic epilepsy. […] In older people: Tumors and strokes. […] In reflex epilepsy, a rare disorder, seizures are triggered predictably by an external stimulus, such as repetitive sounds, flashing lights, video games, music, or even touching certain parts of the body.
- #64 What is temporal lobe epilepsy?https://www.epsyhealth.com/seizure-epilepsy-blog/what-is-temporal-lobe-epilepsy
Temporal lobe epilepsy is the most common cause of focal seizures and it affects tens of thousands of people around the world. […] Temporal lobe epilepsy can begin at any time in life, although it most often starts between the ages of 10 and 20. […] Oftentimes, doctors do not know exactly why someone begins having temporal lobe seizures. However, there are some common causes: Brain injuries from accidents, Diseases and infections when you were a child, Febrile seizures – if you had high temperatures caused by a fever that put you into a seizure when you were a baby, Brain malformations or growths on the brain.
- #65 TLE⯠| Ohio State Medical Centerhttps://wexnermedical.osu.edu/brain-spine-neuro/epilepsy/temporal-lobe
Epilepsy is a complex disease, with different types of seizures that may start in different parts of the brain. […] The most common form of focal epilepsy is temporal lobe epilepsy. […] Youll be diagnosed with temporal lobe epilepsy (TLE) if this is where your seizures start. […] There are two types of TLE, which usually begin between the ages of 10 and 20, but can start at any age: […] Almost 80% of all temporal lobe seizures are due to MTLE.
- #66 Temporal lobe epilepsy with amygdala enlargement: a subtype of temporal lobe epilepsy | BMC Neurology | Full Texthttps://bmcneurol.biomedcentral.com/articles/10.1186/s12883-014-0194-z
In this study, the seizure onset was late, and FDG-PET scanning was performed within a few years after onset. This may imply that the epileptogenicity in the amygdala was mild and developed slowly. […] TLE with AE probably represents a distinct nosological and probably less homogeneous syndrome which is most likely a subtype of TLE without ipsilateral HS.
- #67 Temporal Lobe Epilepsy: From Etiology to Treatment | Frontiers Research Topichttps://www.frontiersin.org/research-topics/20585/temporal-lobe-epilepsy-from-etiology-to-treatmentundefined
Temporal lobe epilepsy (TLE) represents the most common focal epilepsy syndrome in adulthood. […] Among the different etiologies, hippocampal sclerosis in adults and focal cortical dysplasia in children are the most common pathologies identified on magnetic resonance imaging (MRI), and have advanced and accurate diagnostic and therapeutic approaches. […] However, in around 20-30% of refractory patients with TLE, brain MRI does not demonstrate any epileptogenic lesion. The etiologies behind this non-lesional TLE is being clarified by the identification of new pathologies that do not leave a specific trace in brain MRI, or in which this trace is difficult to identify. […] Difficult to diagnose etiologies in TLE include some forms of autoimmune epilepsies, TLE with a genetic origin, and occult temporal pole encephaloceles, that might be considered both in controlled and refractory non-lesional TLE.
- #68 Temporal Lobe Epilepsy: From Etiology to Treatment | Frontiers Research Topichttps://www.frontiersin.org/research-topics/20585/temporal-lobe-epilepsy-from-etiology-to-treatmentundefined
Temporal lobe epilepsy (TLE) represents the most common focal epilepsy syndrome in adulthood. […] Among the different etiologies, hippocampal sclerosis in adults and focal cortical dysplasia in children are the most common pathologies identified on magnetic resonance imaging (MRI), and have advanced and accurate diagnostic and therapeutic approaches. […] However, in around 20-30% of refractory patients with TLE, brain MRI does not demonstrate any epileptogenic lesion. The etiologies behind this non-lesional TLE is being clarified by the identification of new pathologies that do not leave a specific trace in brain MRI, or in which this trace is difficult to identify. […] Difficult to diagnose etiologies in TLE include some forms of autoimmune epilepsies, TLE with a genetic origin, and occult temporal pole encephaloceles, that might be considered both in controlled and refractory non-lesional TLE.
- #69 Temporal Lobe Epilepsy: From Etiology to Treatment | Frontiers Research Topichttps://www.frontiersin.org/research-topics/20585/temporal-lobe-epilepsy-from-etiology-to-treatmentundefined
While significant advances have been made in the diagnosis and treatment of hippocampal sclerosis and cortical dysplasia, diagnosis of other etiologies is challenging, ultimately resulting in held or delayed therapies and worse outcomes. […] This Research Topic focuses on reviewing stablished approaches and novel advances in the translational and clinical research on the etiology, diagnosis and therapy of different causes of TLE. […] The goals of this review series are: (1) to characterize novel, difficult to recognize types and etiologies, such as temporal plus syndromes, temporal encephalocele, autoimmune epilepsy and genetic TLE.
- #70 Focal epilepsy: Causes and clinical features – UpToDatehttps://www.uptodate.com/contents/focal-epilepsy-causes-and-clinical-features
Most of the focal epilepsies are the result of a structural brain abnormality, even though this cannot always be identified. These cases represent most cases of adult-onset epilepsy, although these are common in childhood as well. If imaging studies are normal, the cause remains unknown.
- #71 Temporal lobe epilepsy | Tidsskrift for Den norske legeforeninghttps://tidsskriftet.no/en/2023/01/clinical-review/temporal-lobe-epilepsy
Prolonged febrile seizures in early childhood appear to increase the risk of the limbic form of temporal lobe epilepsy caused by hippocampal sclerosis. […] Focal seizures lasting 12 minutes are typical for patients with temporal lobe epilepsy, irrespective of aetiology and the location of the pathological network. […] Medical options for the treatment of temporal lobe epilepsy include drugs such as lamotrigine, levetiracetam, carbamazepine and oxcarbazepine. This form of epilepsy has previously been considered highly drug-resistant, but a study from 2016 showed that 29 % of patients were able to achieve long-term seizure freedom with drugs. […] The results of surgery are particularly good if the patient has hippocampal sclerosis. Around 70 % of these patients achieve long-term seizure freedom after surgery.
- #72 Temporal Lobe Epilepsy Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York Cityhttps://www.neurosurgery.columbia.edu/patient-care/conditions/temporal-lobe-epilepsy
When the initiation point of recurrent seizures can be traced to the temporal lobe, it is known as temporal lobe epilepsy. Temporal lobe epilepsy may be caused by an injury to the brain, such as a traumatic injury or infection. There are many other causes such as brain tumors, vascular malformations, and developmental abnormalities. […] Temporal lobectomy is the most common epilepsy surgery and is associated with high success rates and low complication rates. One recent study registered a success rate (defined by how many patients were seizure-free at one year) close to 60 percent, compared with 8 percent among patients given medication alone. Clinical experience and careful patient selection may push this number even higher. Other studies have reported higher success rates for carefully selected temporal lobe seizure patients.
- #73https://aesnet.org/abstractslisting/etiology-related-longterm-seizure-outcome-after-epilepsy-surgery-in-temporal-lobe-epilepsy
RATIONALE: Aim of this retrospective study was to correlate etiology of temporal lobe epilepsy (TLE) with long-term seizure outcome after epilepsy surgery. […] CONCLUSIONS: There was no significant difference in seizure outcome between the 4 etiology categories. 73% of the patients with temporal lobe epilepsy had a favourable outcome after epilepsy surgery regardless of the underlying etiology.
- #74https://aesnet.org/abstractslisting/etiology-related-longterm-seizure-outcome-after-epilepsy-surgery-in-temporal-lobe-epilepsy
RATIONALE: Aim of this retrospective study was to correlate etiology of temporal lobe epilepsy (TLE) with long-term seizure outcome after epilepsy surgery. […] CONCLUSIONS: There was no significant difference in seizure outcome between the 4 etiology categories. 73% of the patients with temporal lobe epilepsy had a favourable outcome after epilepsy surgery regardless of the underlying etiology.
- #75 Temporal Lobe Epilepsy Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York Cityhttps://www.neurosurgery.columbia.edu/patient-care/conditions/temporal-lobe-epilepsy
When the initiation point of recurrent seizures can be traced to the temporal lobe, it is known as temporal lobe epilepsy. Temporal lobe epilepsy may be caused by an injury to the brain, such as a traumatic injury or infection. There are many other causes such as brain tumors, vascular malformations, and developmental abnormalities. […] Temporal lobectomy is the most common epilepsy surgery and is associated with high success rates and low complication rates. One recent study registered a success rate (defined by how many patients were seizure-free at one year) close to 60 percent, compared with 8 percent among patients given medication alone. Clinical experience and careful patient selection may push this number even higher. Other studies have reported higher success rates for carefully selected temporal lobe seizure patients.
- #76 Temporal lobe epilepsy | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/temporal-lobe-epilepsy?lang=us
Temporal lobe epilepsy may be due to a veritable menagerie of causes including 1-3: […] mesial temporal sclerosis (MTS): ~70% […] temporal lobe tumors: ~10% […] cortical dysplasia: 5-10% […] vascular malformations: ~5% […] trauma […] infection […] congenital […] temporal pole encephalocele (rare) 4.
- #77 TLE Causes | Ohio State Medical Centerhttps://wexnermedical.osu.edu/brain-spine-neuro/epilepsy/temporal-lobe/causes
Like others with epilepsy, you didnt cause your condition of temporal lobe epilepsy (TLE). […] Almost 25% of all temporal lobe seizures are due to unknown causes. […] Sometimes TLE is the result of scarring in the temporal lobe following brain injury, a severe blow to the head or brain abnormalities that people are born with. […] Its also possible for TLE to develop following a brain infection, such as meningitis or encephalitis, as well as from brain vessel abnormalities, such as arteriovenous malformations or brain conditions like tumors, strokes or dementia. […] Although theres more research needed, genetic mutations or a family history of TLE may also play a role.
- #78 Temporal Lobe Epilepsy: From Etiology to Treatment | Frontiers Research Topichttps://www.frontiersin.org/research-topics/20585/temporal-lobe-epilepsy-from-etiology-to-treatmentundefined
While significant advances have been made in the diagnosis and treatment of hippocampal sclerosis and cortical dysplasia, diagnosis of other etiologies is challenging, ultimately resulting in held or delayed therapies and worse outcomes. […] This Research Topic focuses on reviewing stablished approaches and novel advances in the translational and clinical research on the etiology, diagnosis and therapy of different causes of TLE. […] The goals of this review series are: (1) to characterize novel, difficult to recognize types and etiologies, such as temporal plus syndromes, temporal encephalocele, autoimmune epilepsy and genetic TLE.
- #79 Uncovering why some seizures cause loss of consciousness | Yale Newshttps://news.yale.edu/2024/12/17/uncovering-why-some-seizures-cause-loss-consciousness
Temporal lobe seizures can make part of the brain act as if asleep. […] In temporal lobe epilepsy a common and debilitating form of the disorder seizures often cause those affected to lose consciousness. […] The finding points to new therapeutic opportunities for a disorder without widely effective existing treatment options. […] Available anti-seizure medicines dont work for about a third of people with temporal lobe epilepsy, said Dr. Hal Blumenfeld, the Mark Loughridge and Michele Williams Professor of Neurology at Yale School of Medicine. […] Temporal lobe epilepsy affects around 50 million people worldwide and loss of consciousness is among the most disabling aspects of the disorder, said Blumenfeld, senior author of the study, published recently in the journal Cell Reports. […] If the cause of loss of consciousness could be better understood, new treatments may be able to help prevent it.
- #80 Uncovering why some seizures cause loss of consciousness | Yale Newshttps://news.yale.edu/2024/12/17/uncovering-why-some-seizures-cause-loss-consciousness
What this suggests is that, while these seizures are occurring in the temporal lobe, they are also shutting off circuits deep in the brain responsible for keeping us awake, said Blumenfeld. […] This gives us hope that if we can understand what causes loss of consciousness in temporal lobe seizures, then we can come up with treatments that prevent that loss and reduce some of the burden of this disorder.