Temporal lobe seizure

Alternative names:

psychomotor seizure; seizure - psychomotor; seizure - temporal lobe

Treatment:

The goals of treatment are to perform emergency measures, if necessary, and to reduce the incidence of future seizures.

Emergency treatment may not be required unless the seizure becomes generalized or consciousness is lost. First-aid measures should be performed as appropriate, including protection from injury, prevention of aspiration of vomit or mucus into the lungs, and airway protection or assistance with breathing.

Record details of the seizure and report them to the health care provider. Important details include date and time of the seizure, how long it lasted, which body parts were affected, type of movements or other symptoms, possible causes, and other factors noted.

The treatment of causes may stop the occurrence of seizures. This may include medical treatment of disorders, surgical repair of tumors or brain lesions, or other treatments.

Isolated seizures are usually generalized tonic-clonic (contracting then relaxing) seizures but may occur as temporal lobe seizures. An isolated seizure with an obvious trigger (such as fever or toxic reactions) is treated by removal or treatment of the precipitating (trigger) factor. An isolated seizure without an obvious precipitating cause (normal results of examination, normal EEG, no abnormalities on other testing) may not require treatment.

Oral anticonvulsants (antiseizure medications) are used to prevent or reduce the number of future seizures. Response is individual, and the medication and the dosage may have to be adjusted repeatedly.

An isolated seizure ( with abnormal findings on EEG or other testing) is treated by anticonvulsant medications such as phenytoin, carbamazepine, phenobarbital, or valproic acid.

Multiple, repeated seizures are usually treated with long-term use of phenytoin or carbamazepine.

Follow-up includes reviewing the need for drugs at least yearly. Drugs may be required indefinitely. Plasma drug-level monitoring is important to continue control of seizures and reduce side effects.

Pregnancy, lack of sleep, skipping doses of medications, use of drugs or medications or alcohol, or illness may cause seizures in a person with a previously well-controlled seizure disorder.

Use of informational jewelry or cards (such as Medic-Alert or similar) that indicate a seizure disorder may be advised to aid in obtaining prompt medical treatment if a seizure occurs.

Expectations (prognosis):

Seizures can occur as a single isolated occurrence, closely repeated (recurrent multiple seizures), or at various intervals (episodic, paroxysmal). Seizures that recur with no precipitating factors are most commonly a chronic, lifelong condition (epilepsy).

Seizures that occur singly or in a cluster are commonly caused by an acute condition such as brain injury. They may occur as an isolated incident or may develop into a chronic seizure disorder. Seizures within the first 2 weeks of a brain injury do not necessarily mean that a chronic seizure disorder will develop.

A seizure-free period of 4 years may indicate that reduction or elimination of medications may be possible. There is controversy over the advisability of stopping seizure medications, which should occur only under the supervision of the health care provider.

Serious injury can occur if seizure occurs during driving or when operating dangerous equipment; therefore, these activities may be restricted for persons with poorly controlled seizure disorders.

Infrequent seizures may not severely restrict lifestyle. Work, school, or recreation do not necessarily need to be restricted.

Complications:

• progression to generalized seizures
• recurrent seizures (epilepsy)
• prolonged seizures, closely occurring seizures (status epilepticus)
• injury from falls, bumps, biting self, and so on
• injury from seizure occurring during driving/operating machinery
• aspiration of fluid, pneumonia
• permanent brain damage (stroke or other damage)
• side effects of medications (with or without observable symptoms)

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if:

• this is the first time the person has had seizures or this is a new type of seizure for the person.
• the seizure lasts longer than 2 to 3 minutes. This is an emergency situation.
• repeated seizures occur (over any amount of time). Repeated seizures over a few minutes, or repeated seizures where consciousness is not regained in between (status epilepticus) is an emergency situation.
• any new symptoms occur, including possible side effects of medications, such as changes in mental status (drowsiness, restlessness, confusion, sedation, or others), nausea/vomiting, rash, loss of hair, tremors or abnormal movements, problems with coordination.