[Recognition of temporal lobe epilepsy in adults]

Temporal lobe epilepsy has a subtle and diverse symptomatology, and therefore temporal lobe seizures can initially be misdiagnosed. Here we discuss 3 patients with this type of epilepsy, but with completely different presentations. The first, a 67-year-old woman suffered from episodes of confusion, and later she developed tonic-clonic seizures. The second patient, a 58-year-old man, had auras followed by impaired consciousness and oral automatisms and also developed a type of seizure resembling panic attacks. The third patient, a 65-year-old man, presented with isolated auras. A few years later he developed tonic-clonic seizures, and the diagnosis 'temporal lobe epilepsy' was made. This article discusses differences in presentation between limbic and neocortical temporal lobe epilepsy, as well as the results of EEG and MRI investigations.