Mesial Temporal Lobe Epilepsy (MTLE)

Mesial temporal lobe epilepsy is the most common form of partial human epilepsy in adults.

Location of origin

Mesial temporal lobe epilepsy arises in the hippocampus, the parahippocampal gyrus and the amygdala which are located in the inner (medial) aspect of the temporal lobe of brain.

Causes of Mesial temporal lobe epilepsy

• Mesial temporal lobe sclerosis (MTS) is the major underlying cause of MTLE
• Family history
• Hippocampal sclerosis (HS)
• Small foreign tissue lesions such as hamartomas or glial tumors
• Vascular and congenital malformations
• Gliotic lesions due to trauma or infections
• Traumatic brain injury
• Brain infection
• Brain tumor
• Lack of oxygen to the brain
• Uncontrolled seizures

Symptoms of Mesial temporal lobe epilepsy

Mesial temporal lobe epilepsy usually causes partial (focal) seizures that are localized in the brain. But in some cases, the seizures may become generalized involving the whole brain causing sudden loss of awareness or consciousness. The major symptoms include the following:

• Strange sensations
• Changes in behaviour or emotions
• Muscle spasms
• Convulsions
• Disabling seizures
• Febrile seizures

Diagnosis of Mesial temporal lobe epilepsy

The diagnosis of mesial temporal sclerosis not only requires thorough physical and neurological examination of the patient but also require magnetic resonance imaging (MRI) scan for confirmed diagnosis.

Treatment of Mesial temporal lobe epilepsy

Mesial temporal lobe epilepsy is typically resistant to antiepileptic drugs. That is why most of the cases are treated by surgical intervention either by Anteromesial temporal resection or stereotactically implanted intracerebral electrodes. Surgery is considered a better option for patients who do not respond to antiepileptic drugs.

Authored by Dr. Shyam Sundar K