Cases of Temporal Lobe Epilepsy

Temporal lobe epilepsy (TLE) is the most clinically common type of intractable epilepsy that has been extensively studied in clinical and basic research. Seizures originating from different structures of the temporal lobe have different symptoms. Depending on anatomic and clinical characteristics, TLE can be classified into medial temporal lobe epilepsy and neocortical temporal lobe epilepsy. The temporal lobe is closely connected in function to other brain regions and structures via cortical connections, limbic system, and extensive fiber connections. The upper part of the temporal lobe is delimited from the frontal lobe by the lateral fissure, and the posterior part of temporal lobe is separated from the lateral occipital cortex by an imaginary line form the supper margin of the parieto-occipital sulci to the anterior occipital notch (about 4 cm anterior to the occipital pole). The lateral temporal lobe is divided into the superior temporal gyrus, the middle temporal gyrus, and the inferior temporal gyrus by the superior temporal sulcus and the inferior temporal sulcus, which are distributed by longitude. In the postmedian part of the superior temporal gyrus, the short transverse gyrus that passes into the lateral fissure and forms the inferior wall of the lateral fissure is the transverse temporal gyri, which is the auditory center (areas 41 and 42). The posterior part of the superior temporal gyrus is the auditory language center, which is area 22. The base of the temporal lobe is mainly composed of the gyrus lateral occipito-temporalis (fusiform gyrus) and the medial parahippocampalis gyrus. The structure of the medial temporal lobe includes the hippocampal, the parahippocampal gyrus, and the amygdala complex. The hippocampal is a collective term that includes the hippocampus, the dentate gyrus, and a number of cortices closely related to the parahippocampal gyrus. The parahippocampal gyrus, together with the cingulate cortex and olfactory cortex, forms the limbic lobe, which influences the activity of visceral organs, emotional responses, behavioral activity, and state of mind. The amygdala complex is a subcortical mass of gray matter located over the medial temporal lobe, deep in the uncus of gyrus parahippocampalis. The amygdala complex is a part of the rhinencephalon and also an important structure of the limbic system, involved in olfactory recognition and visceral and endocrine responses due to emotion and motivation, as well as somatosensory and somatomotor activities.