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A temporal lobe seizure is a type of seizure that primarily involves the temporal lobes of your brain. The temporal lobes are the portions of your brain that extend from the temples to just past your ears.

Temporal lobe seizures are due to abnormal electrical activity in the temporal lobe. Sometimes these seizures are caused by an abnormality in the temporal lobe, such as a tiny scar or tumor, but often no identifiable cause is found.

Repeated seizures characterize a disorder called epilepsy. A variety of treatments may help control temporal lobe seizures.

Temporal lobe seizures frequently are preceded by an aura, which is caused by an electrical discharge. Auras can consist of:

• A sudden sense of unprovoked fear
• A deja vu experience
• The sudden occurrence of a strange odor or taste
• A rising sensation in the abdomen

The aura is actually a small seizure itself. If the electrical discharge spreads to other regions of the brain, rhythmic muscle contractions or jerking and a loss of consciousness can occur.

Temporal lobe seizures are characterized by one- to two-minute episodes of loss of awareness or contact with your surroundings. During a temporal lobe seizure, you may smack your lips, swallow repeatedly or pick at things with your fingers. Such activities are called automatisms. After a temporal lobe seizure, you may be confused for a few minutes and may have difficulty speaking. Many people have no memory of the events that occurred during their temporal lobe seizure.

Your behavior during a temporal lobe seizure may appear to be deliberate to onlookers. People having these types of seizures have been mistaken for being drunk, taking drugs or having a mental illness.

During normal waking and sleeping, your brain cells produce various electrical discharge patterns. If the electrical discharges by your brain cells become abnormally synchronized, a convulsion or seizure occurs. The abnormal firing of your brain cells can remain localized to a small area or can spread rapidly to involve your entire brain.

Temporal lobe seizures are a common example of a seizure type known as a complex partial seizure. Complex partial seizures are a common type of seizure. Other types of seizures include grand mal seizures and petit mal seizures. Petit mal seizures, also known as absence seizures, are commonly confused with temporal lobe seizures.

Half the people with complex partial seizures also have grand mal seizures. Grand mal seizures that occur in someone who has complex partial seizures are called secondary generalized seizures.

Sometimes, the cause of temporal lobe seizures is unknown. Known causes of seizures include:

• Previous brain trauma. Traumatic head injuries, such as those sustained in automobile accidents or serious sports injuries, can cause seizures.
• Brain tumor. Although a brain tumor is an uncommon cause, a seizure may be the first indication of a brain tumor.
• Vascular system problems. Blood vessel disorders, such as arteriovenous malformation (AVM), can be a cause of seizures.
• Infection. An inflammation of your brain, such as that caused by meningitis or encephalitis, may trigger a seizure.

Seek medical advice when any of the following occur:

• The seizure is prolonged.
• A second seizure immediately follows.
• New signs or symptoms appear.

If you see someone having a temporal lobe seizure develop symptoms indicative of a grand mal seizure, such as rhythmic muscle contractions or jerking, call for medical help immediately and then follow these tips:

• Gently roll the person onto one side and put something soft under his or her head.
• Loosen tight neckwear.
• Don't put anything in the mouth — the tongue can't be swallowed.
• Don't try to restrain the person. Look for a medical alert bracelet, which may indicate an emergency contact person and other information.

Your doctor may follow these procedures in making a diagnosis:

• Medical history. Descriptions of your past seizures from you and from family members can help your doctor identify the type and cause of your seizures.
• Physical and neurological examination. Aside from a routine physical examination, your doctor may perform a neurological examination — testing your reflexes, muscle tone and strength, function of your senses, gait, posture, coordination, and balance. Your doctor may also ask questions to test your thinking, judgment and memory.
• Electroencephalography (EEG). This procedure measures the waves of electrical activity your brain produces. Small electrodes are attached to your scalp with paste or an elastic cap as you lie still. You remain still during the test, but at times you may be asked to breathe deeply and steadily for several minutes or to stare at a patterned board. At times, a light may be flashed in your eyes. These actions are meant to stimulate your brain. The electrodes pick up the electrical impulses from your brain and send them to the EEG machine, which records your brain waves on a moving sheet of paper or digitally on a computer screen.
• Magnetic resonance imaging (MRI). Images taken of your brain may help determine what's causing your seizures and can rule out other disorders such as a stroke or a brain tumor.
• Subtraction ictal SPECT coregistered to MRI (SISCOM). This test is a combination of imaging procedures. Ictal single-photon emission computerized tomography (SPECT) produces an image of blood flow in the brain during a seizure, and interictal SPECT produces an image of blood flow in the brain when no seizures are occurring. The two images are then compared using a technique called subtraction imaging that shows where blood flow related to the seizures is originating. The subtraction image is then superimposed onto an MRI of the brain, which allows doctors to see where in the brain blood flow is increased during seizures.
• Blood tests. These tests may reveal a chemical imbalance in your blood or presence of toxic substances. Blood tests may also exclude other causes of seizures.
• Spinal tap (lumbar puncture). Removing a small sample of fluid for laboratory analysis may reveal evidence of an infection or inflammation that may be causing your seizures. A spinal tap is usually performed only on people who have a sudden onset of seizures for which the cause isn't known.

Having recurrent seizures may put you and others at risk of physical harm. A seizure that produces either loss of awareness or control can be dangerous if you're driving a car, swimming, working at heights or operating equipment. Many states have licensing restrictions related to your ability to control seizures. For children, seizure disorders may result in limitations on physical activities, such as swimming or contact sports. In addition, for both children and adults, seizures can produce injuries associated with falling.

A variety of treatments may help control temporal lobe seizures, including:

• Medications. Many medications can effectively reduce or eliminate the number of seizures for some people. Finding the right medication and dosage can be complex. Standard medications to control temporal lobe seizures include phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol), valproic acid (Depakene), divalproex (Depakote), gabapentin (Neurontin), phenobarbital, oxcarbazepine (Trileptal), lamotrigine (Lamictal), topiramate (Topamax), felbamate (Felbatol), tiagabine (Gabitril), levetiracetam (Keppra) and zonisamide (Zonegran). Medications may not completely control seizures. Complex partial seizures are harder to control with medication than are other seizures. Some people with temporal lobe seizures keep having seizures despite trying several medications. Most people with complex partial seizures need to continue taking medications for life. Some seizure medications are associated with birth defects. However, if you're pregnant, continued seizures can be harmful to you and your baby. If you have epilepsy and you're considering becoming pregnant, talk to your doctor.
• Surgery. For temporal lobe seizure disorders that don't respond well to medications, surgery may be an option. You'll need an evaluation at a comprehensive epilepsy center to see if you're a good candidate for surgery. The evaluation typically involves identifying the site where your seizures originate — this is achieved through magnetic resonance imaging scans of your brain — and hospitalization to record your seizures on videotape and with electroencephalography.
• Vagus nerve stimulation. Your doctor may suggest a device called a vagus nerve stimulator if medications are ineffective or cause serious side effects and surgery isn't an option. The stimulator is implanted into your chest under the collarbone. Wires from the stimulator are wrapped around the vagus nerve in your neck. The vagus nerve connects the lower part of your brain to your heart, lungs and gastrointestinal tract. The device turns on and off according to an adjustable program. It's not clear how brain stimulation via the vagus nerve inhibits seizures. You should be evaluated in a comprehensive epilepsy center to determine if you are a good candidate for this device.

If you have a seizure disorder, wear a medical bracelet to help emergency medical personnel. The bracelet should state whom to contact in an emergency and what medications you use.

Skipping medications, poor sleep, alcohol, drugs, illness and pregnancy can increase the likelihood that you'll have a seizure.

You may also have to limit activities such as swimming, skiing, working at heights, driving and operating other equipment. Doing so may prevent physical harm. Some states have laws requiring such restrictions depending on how well you're able to control your seizures.