Temporal Lobe Seizure – Diagnosis and Treatment

Diagnosis

Doctors use several steps and tools to figure out if someone has seizures from the temporal lobe. They start by asking about the person’s symptoms, medical past, and what others saw during the events.

This can include if the person felt déjà vu, sudden fear, trouble speaking, confusion, headache, or changes in vision and emotions.

A neurological exam checks how well the brain and nerves are working. This includes looking at movement, muscle control, speech, mental function, and responses to touch or pain.

Doctors use blood tests to check for infection, problems with blood sugar, genetic causes, and balance of salt or chemicals in the body.

They sometimes include tests for rash or signs of recent illness if they suspect a brain infection or encephalitis. Doctors use an electroencephalogram (EEG) to check the brain’s electrical signals.

They place small sensors on the scalp to record brain activity. Abnormal patterns can show a risk for seizures. Video EEG monitoring can record seizures on camera and connect symptoms to brain wave changes.

Imaging tests help spot changes in the brain that may cause seizures:

Imaging Method	What It Shows
CT Scan	Finds tumors, bleeding, or cysts.
MRI	Shows more detail and can find scars, strokes, or tumors.
PET Scan	Looks at brain activity and spots problem areas.
SPECT Scan	Maps blood flow during a seizure, points to the first spot of abnormal activity.
SISCOM	Combines detailed blood flow and MRI images for clearer results.

Doctors may use several tests to get the full picture, especially if there is a history of brain injury, stroke, meningitis, tumors, or when the symptoms are not clear.

Knowing the exact cause helps doctors decide on the best treatment and how to lower the chance of future seizures.

Doctors diagnose temporal lobe seizures by checking for warning signs called auras, which can be feelings, smells, or visions before a seizure.

Sometimes, partial or focal seizures happen without loss of awareness, while others may include convulsions or loss of consciousness.

Doctors testing teenagers and adults also look at alcohol withdrawal, family history of epilepsy, and past head trauma. Changes in brain structure, such as hippocampal atrophy, can be linked to frequent seizures.

Treatment

Medicines for Controlling Seizures

Doctors prescribe a range of medicines to help manage epilepsy, especially temporal lobe epilepsy. Common options include drugs from a group called anti-seizure medications or anticonvulsants.

These are used to reduce how often seizures happen while limiting side effects such as tiredness, dizziness, or weight changes.

Examples of commonly prescribed drugs include those in the following classes:

• Sodium channel blockers
• GABA enhancers
• Glutamate blockers
• Calcium channel inhibitors
• Drugs that regulate neurotransmitter release

Some people may also take a benzodiazepine-based anti-seizure drug or newer anticonvulsants under close medical guidance.

Seizure medicines do not always stop seizures completely. Some people may have side effects, and a few may not see much improvement with medicines alone.

It is important to talk to a healthcare provider about which medication is the safest and most effective, especially if other health conditions or medicines are involved.

Table: Common Anti-Seizure Medicines and Their Side Effects

Medicine Name	Common Side Effects
Sodium channel blockers	Dizziness, drowsiness, gum issues
GABA-related medications	Drowsiness, memory problems, poor coordination
Glutamate inhibitors	Weight loss, difficulty thinking
Broad-spectrum anticonvulsants	Weight gain, tremor, rash, headache
Calcium channel inhibitors	Mood changes, fatigue

Always ask a healthcare provider about possible interactions with other medicines, including birth control pills.

Special Diets for Seizure Reduction

Diet can affect epilepsy control, especially in people whose seizures are hard to manage with medicine alone. The ketogenic diet is a popular option.

This plan is very high in fat, very low in carbohydrates, and moderate in protein. It may help some people have fewer seizures, but the diet is strict and can be hard to follow.

Other diets that are less strict but may help some include:

• Low glycemic index treatment
• Modified Atkins diet

Research is ongoing to see how well these diets work for different types of epilepsy. A healthcare provider or dietitian can help decide if dietary treatment is right for someone.

Procedures and Surgical Options

When medicines and diets are not enough, doctors may recommend other treatments. Doctors can perform surgical treatment to remove or destroy the part of the brain causing seizures.

This is most common in people with mesial temporal lobe epilepsy that does not respond to other treatments. Surgeons may use open surgery, like temporal lobectomy, or more focused surgery like MRI-guided laser therapy.

Surgery best fits those who have seizures starting from a single spot in the brain. It is not right for everyone, especially if surgery risks speech, memory, or movement.

Doctors may also use devices:

• Vagus Nerve Stimulation (VNS): Surgeons place a small device in the chest to send electrical signals through the vagus nerve. These signals go to the brain and may cut down on seizures.
• Responsive Neurostimulation (RNS): Doctors place a device in or on the brain. It responds to early signs of seizure activity with small bursts of electricity, aiming to stop the seizures before they happen.
• Deep Brain Stimulation (DBS): Surgeons place thin wires deep in the brain. They connect the wires to a pacemaker-like device under the skin in the chest. The device sends regular electrical signals to help manage seizures.

These procedures do not cure epilepsy but may reduce how often and how severe seizures happen.

Table: Common Procedures for Hard-to-Treat Epilepsy

Name	How It Works	Who May Benefit
Epilepsy Surgery (resection)	Removes seizure focus	Seizures start in one brain area
Vagus Nerve Stimulation (VNS)	Stimulates nerve in neck	Those not candidates for surgery
Responsive Neurostimulation	Reacts to brain activity	Focal seizures, not a surgery option
Deep Brain Stimulation (DBS)	Ongoing electrical impulses	Resistant to medicine, surgery risk

Pregnancy and Medicine Use in Epilepsy

Many people with epilepsy can have healthy pregnancies. However, some anti-seizure drugs can put an unborn baby at risk for birth defects.

Valproic acid is linked to a higher chance of cognitive problems and conditions like spina bifida in babies. Most experts advise against using it during pregnancy if possible.

It is essential to discuss with a healthcare provider before becoming pregnant. Sometimes, medicine doses may need to change.

The main aim is to use the lowest possible dose of a safe medicine that prevents most seizures, to protect both mother and baby.

Effects of Seizure Drugs on Birth Control

Some epilepsy medicines can make birth control pills less effective. This can increase the risk of pregnancy.

Talk to a healthcare provider about whether a change in birth control method is needed. In some cases, people may need to use a different type of birth control or adjust which anti-seizure medicine they take to avoid these problems.

Brain Device for Seizure Management

Doctors may use a type of device, also called a brain pacemaker, to track activity in the brain. Surgeons put it under the skin and attach wires to the outside parts of the brain.

If the device senses abnormal brain activity, it sends out small electric signals to stop a seizure from getting worse. This option is for people who do not do well with medicines or other treatments.

Day-to-Day Management and At-Home Tips

Staying Safe in Daily Life

To help avoid accidents from seizures, people can make the home and activities as safe as possible. People who ride bikes or play sports should wear a helmet to protect their head.

In the bathroom, taking showers instead of baths lowers drowning risk. For anyone who wants to swim or go boating, it is best not to go alone and always have someone close by.

At home, using chairs with arms and choosing furniture with rounded edges can help prevent injuries if a seizure happens. Adding thick carpets or soft mats can cushion falls.

It also helps to pad sharp corners on tables or counters. For extra safety, wearing a medical alert bracelet lets helpers know how to respond if a seizure starts.

Drivers must check local rules about when it is safe to drive, as many places require people to be seizure-free for a certain period.

A simple safety checklist could look like this:

Activity	Safety Action
Bike Riding	Wear a helmet
Bath/Shower	Shower alone, bath with help
Swimming/Boating	Always have someone nearby
Furniture Safety	Pad sharp corners, use armchairs
Flooring	Choose thick carpets/mats
Medical Alert	Wear a medical ID bracelet

What to Do During a Seizure

Knowing how to help someone during a seizure can make things safer for everyone. If someone is having a seizure:

• Gently roll the person to their side.
• Place a soft object, like a folded jacket, under their head.
• Loosen anything tight around their neck, like a tie.
• Move objects out of the way that could cause harm.
• Never put anything in their mouth.
• Do not try to hold the person down or stop their movements.

It is best to stay nearby and watch carefully. Wait with the person until the seizure ends and medical help is available, if needed. It helps to keep track of how long the seizure lasts, as this information is helpful for emergency responders.

Post this quick checklist somewhere visible:

• Stay calm.
• Note when the seizure starts and stops.
• Help steer the person away from danger.
• Let medical staff know exactly what happened.

Giving family, teachers, and coworkers these simple steps makes it easier for everyone to react quickly and correctly if a seizure occurs.

Finding Support

Support at Home

Family support is important for people living with seizures. Sharing information about the condition helps everyone understand what to expect.

Family members are encouraged to ask questions and share any concerns they have. Open conversations can make the home safer and more comforting for everyone.

Getting Help at Work

It is helpful to speak with supervisors about seizures and explain how these might affect work. Employees should discuss what actions are needed if a seizure happens during work hours. Using a checklist or written plan can be helpful:

What to Share	Who to Inform
Special needs during seizures	Supervisor
Safety measures	Coworkers
Emergency contacts	Human Resources

Being clear and open helps build understanding and support in the workplace.

Building Connections

No one has to go through this alone. Connecting with family, friends, or support groups can reduce feelings of isolation.

Getting Ready for Your Visit

Steps You Can Take

Before the appointment, gather important details about any seizure you experienced.

Record when and where the seizure took place, what signs or symptoms you noticed, and about how long it lasted. If someone saw the seizure happen, ask them to share what they remember.

• Prepare for possible instructions ahead of time. When booking the visit, ask if you need to do anything before arriving, like fasting or changing your medication schedule.
• Make a note of personal details. Include major stressors, changes in your daily life, or updates about your health.
• List all medications or supplements. Write down everything you take, including the name and amount, such as prescription drugs, over-the-counter medicine, vitamins, and herbal products.
• Consider bringing a support person. Invite a family member or friend to go with you. They can help remember information and share what they saw if they witnessed your seizure.
• Prepare questions to ask. Writing down your main concerns helps you focus during the appointment. Common questions include:

Question	Purpose
What caused my seizure?	Understand the possible reasons.
What tests will I need?	Learn about the next steps.
What treatment do you recommend?	Find out about management options.
Could I have another seizure?	Know about the chances of future episodes.
How can I stay safe if it happens again?	Learn safety steps.
How do my other health issues affect this?	Coordinate care.
Are there any restrictions I should follow?	Know about activity or driving limits.
Are materials or websites available for more info?	Get credible resources.

Ask about anything you do not understand or that worries you.

Questions You May Be Asked by the Healthcare Team

During the appointment, the healthcare professional may ask a mix of questions to learn more about what happened. These questions may include:

• Can you describe what the seizure was like from your perspective?
• Was anyone with you during the seizure, and can they describe what they saw?
• What sensations or warning signs did you notice before or after the event?
• Have you had seizures before, or any other problems with your brain or nerves?
• Has anyone in your immediate family been diagnosed with seizures or epilepsy?
• Have you recently traveled to another country?

If you share clear and honest answers to these questions, the healthcare team can create a better care plan. Give as much detail as you can remember.

Bring any notes or information you have written down to make the discussion easier.