CHAPTER 4 – Temporal Lobe Epilepsy

This chapter discusses aspects of temporal lobe epilepsy (TLE) and highlights relevant information to interpret the data obtained from magnetic resonance imaging (MRI). TLE is characterized by seizures originating in or primarily involving temporal lobe structures. Most clinicians distinguish between mesial temporal epilepsy and neocortical or lateral temporal lobe epilepsy. The medial structures that are important for the generation of seizures include the hippocampus, amygdala, and parahippocampal gyrus, although hippocampal sclerosis is by far the most common cause of intractable TLE. A large proportion of adults and children with partial epilepsy have defined brain abnormalities visualized on appropriate optimized imaging. Advances in image analysis techniques and MR technologies have widened the scope of sensitivity of the detection process of epilepsy. Now MR technologies detect abnormalities ranging from gross macroscopic structural changes to functional metabolic and neurophysiologic abnormalities. New techniques and the exciting potentials suggest that this is only the beginning of uncovering the basis of epilepsy and its effects on the brain.