1-Temporal lobe epilepsy (TLE) was defined in 1985 by the International League Against Epilepsy (ILAE) as a condition characterized by recurrent unprovoked seizures originating from the medial or lateral temporal lobe. The seizures associated with temporal lobe epilepsy consist of simple partial seizures without loss of awareness and complex partial seizures (ie, with loss of awareness). The individual loses awareness during a complex partial seizure because the seizure spreads to involve both temporal lobes, which causes impairment of memory. The partial seizures may secondarily generalize.
2-Although the causes of temporal lobe epilepsy are widely varied, hippocampal sclerosis is the most common pathologic finding. Hippocampal sclerosis involves hippocampal cell loss in the CA1 and CA3 regions and the dentate hilus. The CA2 region is relatively spared. The clinical correlate on neuroimaging on MRI is called mesial temporal lobe sclerosis.
3-The etiologies of temporal lobe epilepsy include the following:
a-Infections, eg, herpes encephalitis, bacterial meningitis, neurocysticercosis
b-Trauma producing contusion or hemorrhage that results in encephalomalacia or cortical scarring; difficult traumatic delivery such as forceps deliveries
c-Malignancies (eg, meningiomas, gliomas, gangliomas)
d-Vascular malformations (ie, arteriovenous malformation, cavernous angioma)
e-Cryptogenic: A cause is presumed but has not been identified.
f-Idiopathic (genetic): This is rare. Familial temporal lobe epilepsy was described by Berkovic and colleagues3 , and partial epilepsy with auditory features was described by Scheffer and colleagues.
4-Hippocampal sclerosis produces a clinical syndrome called mesial temporal lobe epilepsy (MTLE).
http://emedicine.medscape.com/article/1184509-overview
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