Anatomical and Clinical correlation in the postraumatic temporal lobe epilepsy

Abstract

OBJECTIVE: To study the relationship between the traumatic temporal lobe lesion,-and posterior epilep­tic seizures. MATERIAL ANO METH0DS: A patient suffered at three years of age. a small bullet wound in his right eyeball. At seven years of age, he had partía) simple seizures that were treated successfully with phenobarbital. The drug was sus­pended after an asymptomatic period of thirteen years. The antiepileptic treatment was restored because the same seizures reappeared two years later. At the present moment. the patient is free of symptoms. Sorne radiography (Rx). computed tomography (CT) and electroencephalograms (EEG) were made. RESULTS: The Rx and CT showed a small bullet in the cerebral tissues just over the temporal bone in the petrosal ( part. The EEG showed a right frontotemporal focus. Discussion: Thc expression "temporal lobe epilepsy" (TLE) is based on anatomical localizations and is applied to epileptic conditions characterized by repeated simple partial seizures and complex partial seizures which com­mencer principally in the mesial temporal region. Our patient had symptomatology of simple partial seizures, sometimes with secondary generalization. Al the begin­ning of the seizures the patient had reponed experiences having subjective qualities (named ·' experiential pheno­mena") of perceptual (eg: visual hallucinations) and mne­monic (eg: "deja vu" illusion) characteristics and also vegetative alterations. We want to know the correlation between the patient's symptomatology and the traumatic cerebral lesion. The small bullet followed a lineal dircc­tion from the right orbitary sphenoidal fissure; later, it pas­sed. outside the cavernous canal and the pituitary fosse. through the internal region of the anterior temporal lobe, and. finally. it stopped just over the vertex of the temporal bone in the Petrosal part. Neither the Gasser ganglion nor the internal carotid artery was affected. The seizure symptomatology was only related to the injury produced by the course of a small bullet inside the right temporal mesial region.