Figure. Lesions Commonly Associated With Temporal
Lobe EpilepsyGraphic Jump Location
Figure (facing page). The temporal lobes
have memory, emotional, auditory, olfactory, and higher visual functions.
They consist of a phylogenetically older medial portion and a newer, lateral
portion. Seizures arising in either region cause auras (simple partial seizures)
that often progress to impaired consciousness with oral and hand automatisms.
Medial (limbic) areas often cause abdominal sensations and fear while lateral
(neocortical seizures) often cause déjà vu, dreamy state, abdominal
sensation, tinnitus, and vertigo.
Top panel, position of imaging planes
A and B in middle and bottom panels. Left, three-quarter view of the brain
showing the hippocampus and adjacent structures. Right, midsagittal section
showing the medial surface of the left hemisphere (brainstem removed) and
structures deep to the plane of section.
Middle panel, Mesial temporal
sclerosis (MTS). Left, a magnetic resonance image (MRI) of a patient with
MTS; arrowhead indicates atrophic left hippocampus. Mesial temporal sclerosis
is associated with a history of febrile seizures, especially prolonged ones.
Right, anatomic structures in this coronal view and enlargement of detail
from MRI showing atrophic left hippocampus.
Bottom panel, neocortical
dysplasia. Left, inversion recovery image showing coronal view of the anterior
temporal lobes in a patient with neocortical dysplasia (a malformation of
cortical development) involving the left anterior temporal neocortex (temporal
pole). Note thickening of the cortex (arrowhead), abnormal architecture, loss
of differentiation between gray and white matter, and paucity of white matter.
Lesions of the left temporal pole impair retrieval of unique names of places,
persons, and objects. Right, anatomic structures in this coronal view.