"I get the strangest feeling; most of it can’t be put into words. The whole world suddenly seems more real at first; it’s as though everything becomes crystal clear. Then I feel as if I’m here but not here, kind of like being in a dream. It’s as if I’ve lived through this exact moment many times before. I hear what people say, but they don’t make sense. I know not to talk during the episode because I just say foolish things. Sometimes I think I’m talking, but later people tell me that I didn’t say anything. The whole thing lasts a minute or two."
Temporal Lobe Epilepsy (TLE) means that the seizures arise in the temporal lobe of the brain. Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with feelings of fear, pleasure, or unreality. A patient may also report an odd smell, an abdominal sensation that rises up through the chest into the throat, an old memory or familiar feeling, or a feeling that is impossible to describe.
The most common seizure type in TLE is a complex partial seizure. During complex partial seizures people with TLE tend to perform repetitive, automatic movements (called automatisms), such as lip smacking and rubbing their hands together. Three-quarters of people with TLE also have simple partial seizures, and about half have tonic-clonic seizures at some time. Note: some people with TLE experience only simple partial seizures.
Temporal lobe seizures usually begin in the deeper portions of the temporal lobe. This area is part of the limbic system, which controls emotions and memory. This is why the seizures can include a feeling of déjà vu, fear, or anxiety, and why some people with TLE may have problems with memory and depression.
In most cases, the seizures associated with TLE can be fully controlled with medications used for partial seizures. If drugs are ineffective, brain surgery is often an option for patients with TLE. Temporal lobectomy is the most common and successful form of epilepsy surgery. Vagus Nerve Stimulation can also be beneficial in cases where temporal lobectomy is not recommended or has failed. At the NYU CEC we offer surgical treatments for TLE tailored to each patient.