Can temporal lobe epilepsy cause changes in personality

Overview

Temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for short-term memory. Some symptoms of a temporal lobe seizure may be related to these functions, including having odd feelings — such as euphoria, deja vu or fear.

Temporal lobe seizures are sometimes called focal seizures with impaired awareness. Some people remain aware of what's happening, but during more-intense seizures, you might look awake but be unresponsive. Your lips and hands may make purposeless, repetitive movements.

Temporal lobe seizures may stem from an anatomical defect or scar in your temporal lobe, but the cause is often unknown. Temporal lobe seizures are treated with medication. For some people who don't respond to medication, surgery may be an option.

Symptoms

An unusual sensation (aura) may precede a temporal lobe seizure, acting as a warning. Not everyone who has temporal lobe seizures has auras, and not everyone who has auras remembers them.

The aura is actually the first part of a focal seizure before consciousness is impaired. Examples of auras include:

• A sudden sense of unprovoked fear or joy
• A deja vu experience — a feeling that what's happening has happened before
• A sudden or strange odor or taste
• A rising sensation in the abdomen, similar to being on a roller coaster

Sometimes temporal lobe seizures impair your ability to respond to others. This type of temporal lobe seizure usually lasts 30 seconds to two minutes. Characteristic signs and symptoms include:

• Loss of awareness of surroundings
• Staring
• Lip smacking
• Repeated swallowing or chewing
• Unusual finger movements, such as picking motions

After a temporal lobe seizure, you may have:

• A period of confusion and difficulty speaking
• Inability to recall what occurred during the seizure
• Unawareness of having had a seizure
• Extreme sleepiness

In extreme cases, what starts as a temporal lobe seizure evolves into a generalized tonic-clonic (grand mal) seizure — featuring convulsions and loss of consciousness.

When to see a doctor

Seek immediate medical help if any of the following occurs:

• The seizure lasts more than five minutes.
• Breathing or consciousness doesn't return after the seizure stops.
• A second seizure follows immediately.
• Recovery isn't complete after the seizure is over.
• Recovery is slower than usual after the seizure is over.
• You have a high fever.
• You're experiencing heat exhaustion.
• You're pregnant.
• You have diabetes.
• You've injured yourself during the seizure.

If you experience a seizure for the first time, seek medical advice.

Seek medical advice in these circumstances:

• If you think you or your child is having seizures
• When the number or severity of seizures increases significantly without explanation
• When new signs or symptoms of seizures appear

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Causes

Often, the cause of temporal lobe seizures remains unknown. However, they can be a result of a number of factors, including:

• Traumatic brain injury
• Infections, such as encephalitis or meningitis, or a history of such infections
• A process that causes scarring (gliosis) in a part of the temporal lobe called the hippocampus
• Blood vessel malformations in the brain
• Stroke
• Brain tumors
• Genetic syndromes

During normal waking and sleeping, your brain cells produce varying electrical activity. If the electrical activity in many brain cells becomes abnormally synchronized, a convulsion or seizure may occur.

If this happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that originates in one of the temporal lobes.

Complications

Over time, repeated temporal lobe seizures can cause the part of the brain that's responsible for learning and memory (hippocampus) to shrink. Brain cell loss in this area may cause memory problems.

Feb. 24, 2021

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