Psychomotor epilepsy is an old name for what is now called temporal lobe epilepsy, the most common form of focal epilepsy in which seizures start in one or both temporal lobes in the brain, called focal onset seizures.
The cause of temporal lobe epilepsy (psychomotor epilepsy) is not always known, but seizures may occur due to:
- Traumatic brain injury including head trauma with loss of consciousness or birth injury
- Infections such as encephalitis or meningitis that happen early in life
- A process that causes scarring (gliosis) in a part of the temporal lobe called the hippocampus
- Blood vessel malformations in the brain
- Brain tumors
- Stroke
- Genetic syndromes
- A history of febrile seizures
- Most people who have febrile seizures do not develop temporal lobe epilepsy
What Are Symptoms of Psychomotor Epilepsy?
Symptoms of temporal lobe epilepsy (psychomotor epilepsy) may include:
- Auras
- Auditory aura, such as buzzing or hearing a specific sound
- Sensing an unusual smell
- A fixed stare
- Confusion or lack of awareness of what is going on around them
- Fumbling with the fingers
- Lip-smacking
- Unusual posturing (movement or positioning) in an arm
- Speaking gibberish
- Loss of ability to speak in a sensible manner
- Tonic-clonic jerking
- Weakness after the seizure has stopped
How Is Psychomotor Epilepsy Diagnosed?
There is no single test used to diagnose temporal lobe epilepsy (psychomotor epilepsy). A diagnosis starts with patient history and physical examination, along with tests such as:
- Neurological exam
- Blood tests
- To check for signs of infections
- To screen for genetic conditions
- Blood sugar levels
- Electrolyte imbalances
- Electroencephalogram (EEG)
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Single-photon emission computerized tomography (SPECT)
What Is the Treatment for Psychomotor Epilepsy?
Treatment for temporal lobe epilepsy (psychomotor epilepsy) includes:
- Anti-seizure medications
- Brivaracetam (Briviact)
- Cannabidiol oral solution (Epidiolex)
- Carbamazepine (Epitol, Tegretol, Carbatrol, Tegretol XR)
- Cenobamate (Xcopri)
- Clobazam (Onfi, Sympazan)
- Clonazepam (Klonopin)
- Diazepam nasal (Valtoco)
- Diazepam rectal (Diastat)
- Divalproex sodium (Depacon, Depakote, Depakote ER)
- Eslicarbazepine Acetate (Aptiom)
- Ethosuximide (Zarontin)
- Felbamate (Felbatol)
- Fenfluramine (Fintepla)
- Gabapentin (Neurontin)
- Lacosamide (Vimpat)
- Lamotrigine (Lamictal)
- Levetiracetam (Keppra, Keppra XR)
- Lorazepam (Ativan)
- Midazolam nasal (Nayzilam)
- Oxcarbazepine (Oxtellar XR, Trileptal)
- Perampanel (Fycompa)
- Phenobarbital
- Phenytoin (Dilantin)
- Pregabalin (Lyrica)
- Primidone (Mysoline)
- Rufinamide (Banzel)
- Stiripentol (Diacomit)
- Tiagabine hydrochloride (Gabitril)
- Topiramate (Topamax, Qudexy XR, Trokendi XR)
- Valproic acid (Depakene)
- Vigabatril (Sabril)
- Zonisamide (Zonegran)
- Dietary therapy
- A classic ketogenic diet, which is a special high-fat, low-carbohydrate diet
- A modified Atkins Diet, which has some similar components to a traditional ketogenic diet
- Surgery, which usually involves removing the area where the seizures originate
- Devices
- Vagus nerve stimulation (VNS)
- Responsive neurostimulation (RNS)
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Reviewed on 4/13/2022
References
Image Source: iStock Images
https://www.epilepsy.com/learn/types-epilepsy-syndromes/temporal-lobe-epilepsy-aka-tle
https://www.sparrow.org/departments-conditions/conditions/temporal-lobe-seizure