Neurology

	Answer 4 Partial seizures originating in the temporal lobe. Temporal lobe epilepsy is the most common form of epilepsy and has a characteristic presentation. An epigastric, emotional (eg, fear), or olfactory aura may be present. The complex seizure often begins with arrest and stare, and oroalimentary and complex automatisms are common. Posturing of 1 arm may occur contralateral to the seizure focus. The postictal phase is usually notable for disorientation and amnesia. Two types of temporal lobe seizures are recognized: (1) mesial temporal lobe epilepsy, which arises in the hippocampus, parahippocampal gyrus, and amygdale; and (2) lateral temporal lobe epilepsy, which arises in the neocortex. Atypical absence seizures are characterized by prolonged staring and confusion and are commonly seen in children with mental retardation. Gelastic seizures typically manifest as sudden, unprovoked outbursts of emotion, usually laughter. Myoclonic absence seizures manifest as abrupt-onset disorientation and/or unresponsiveness accompanied by bilateral rhythmic myoclonic jerks of severe intensity. Three types of frontal lobe seizures are recognized: (1) those with supplementary motor seizures, (2) those with focal motor seizures, and (3) those with complex partial seizures. Staring unresponsiveness, tonic posturing, and bicycling movements are common manifestations of frontal lobe seizures. Click here to return to the questions
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