Talk:Temporal lobe epilepsy

Contribution by 24.199.250.10

FYI- I am a Biology teacher in South Carolina and a cancer survivor. From age 13 through age 18 I exhibited the symptoms above. I was on the medication Tegretol for control of seizure symptoms and had a brain tumor removed at age 18 in 1990 by doctors at the University of Michigan hospital in Ann Arbor, Michigan. I hope you can use the information above for your site, as my classes have just found you so valuable as a reference. Please feel free to edit as needed. -Michelle McDaid

Reelin role in Temporal lobe epilepsy

Hello! I've been reading a lot lately about the reelin pathway and filling the data into the article, and stumbled on reelin's role in the granule cell dispersion (GCD) in T.L.Epilepsy. If you think it is right, you can take these findings from my reelin article and include them here. (Look in the reelin article, scroll down to the "role in pathology:Temporal Lobe Epilepsy" section) Best regards, --CopperKettle 07:16, 1 June 2006 (UTC)

Hi CopperKettle, I've been to the reelin page, and it does look like this might be a good link to TLE. I'll wait a day or two for feedback from some of the other editors, and then will start to add to and improve this. Do you have the pdfs of the original research you cite on this? If you do, would you mind sending them to edhubbard AT gmail DOT com (I'll also post this to your talk page)? Edhubbard 14:08, 16 August 2006 (UTC)

Reply (by CopperKettle)

Glad to hear that my work was useful, Edhubbard! I cite two papers, of which one is available only as an abstract: Reelin deficiency and displacement of mature neurons, but not neurogenesis, underlie the formation of granule cell dispersion in the epileptic hippocampus, the other has a free full text online:Role for Reelin in the Development of Granule Cell Dispersion in Temporal Lobe Epilepsy

Alas, I have no PDFs of the articles.

I'm not much savvy in the area of epilepsy, so I haven't really burrowed into these findings.. Maybe one should try searching PubMed with keywords like "reelin granule cell dispersion" or "reelin epilepsy". I'll try to, don't know when however. Best regards, --CopperKettle 14:36, 16 August 2006 (UTC)

P.S. Here's another free full text article:

* Reelin Controls Granule Cell Migration in the Dentate Gyrus by Acting on the Radial Glial Scaffold --CopperKettle 05:49, 17 August 2006 (UTC)

Finally made the changes to the article. --CopperKettle (talk) 06:27, 19 August 2008 (UTC)

Article content

As it currently stands, this article isn't a review of temporal lobe epilepsy; it's a hastily-thrown-together hodgepodge of information in support of some nutty theories which purport that religion is a by-product of epilepsy. The cautious reader is advised to take this article with a grain of salt. -ikkyu2 (talk) 22:10, 9 July 2006 (UTC)

Although the current page is somewhat of a mishmash, the connection between TLE and religiosity is actually pretty well established (see, e.g., Ramachandran and Blakeslee, 1998 for some discussion of this). I am currently working on Vilayanur S. Ramachandran and covering many of the unusual neurological effects that he looked at in his book, and came to this page. I'll try to clean it up, but it would be nice to know what the original author had in mind, as there are lots of good refs at the bottom that just aren't linked to in-text citations. Edhubbard 14:05, 16 August 2006 (UTC)

Personally, I'm more concerned that the "Treatments" section seems pretty POV. It comes out clearly biased against medical treatment, which may be fair enough, but still POV. Isn't it possible to point out that some people will do better without (or with low doses of) the meds, without making it look as if this is the case for everyone? Zuiram 22:14, 3 March 2007 (UTC)

I think the section may have been amended since you left that post, Zuiram. It comes across to me as an endorsement of surgery. I would appreciate it if other editors would keep an eye for neutral POV on this topic. Ikkyu2, I hope you are keeping mind that treatments for TLE is an emotional issue. People are always looking for the newer, more effective way to prevent seizures for the people they love, and if they find something that works, they want to get the word out. This page, or at least the section, may always be a hodgepodge.

I made a few edits to a section on driving privileges that appeared in the "symptoms" section. It probably belongs either in "treatment" or in its own section, but I tend not to make bold moves like moving from section to section. :) If someone else feels like doing so, I hope you will.Katharine908 (talk) 12:12, 4 April 2010 (UTC)

Assertion: Joseph smith didn't have TLE, Just because the effects are not well understood, doesn't mean it should be applied to people who are not well understood. I have TLE, a seizure for me is a brief signaling sensation of utter dread, followed by a memory gap and a return to consciousness. I have read the two most comprehensive books accounting Joseph smith jr's life. No man know's my history, and rough stone rolling. Maybe he was utterly insane, or a huge treasure hunting liar. But he wasn't epileptic

face-blindness?

There is a bunch of information on "face-blindness" under Resources but no mention of "face-blindness" throughout the entirety of this article. Why?

I agree, there is nothing that I can see linking TLE (which occurs mostly in the medial temporal lobe) with face-blindness, which is dependent on regions in the posterior inferior temporal lobe of what is known as the fusiform gyrus. I'll wait a few days for more comments, and if not, then I will remove these links, and start to clean up the entry. Edhubbard 14:05, 16 August 2006 (UTC)

I fixed this. ***Ria777 16:47, 6 September 2006 (UTC)

'Mesial'?

Do you mean 'medial' by any chance? 163.1.143.187 18:22, 31 May 2007 (UTC)

No, but it sure looks that way. People kept changing this, so there is now a comment you can see if you edit that section, the line looks like this:
:* [[Mesial<!--yes,mesial is the correct term here, please do not change it to medial-->''' temporal lobe'''
Cheers, CliffC 00:43, 1 June 2007 (UTC)

Recorrected it back to mesial...it looks like someone ignored the comment. It doesn't matter whether medial and mesial are arguably synonymous: virtually all the literature on epilepsy uses "mesial," so there's no reason for us to use a different term on Wikipedia until it becomes commonplace in the literature. Blahdenoma (talk) 05:56, 30 June 2011 (UTC)

Bipolar disiorder

This article and Bipolar disorder link to one another. Why? --Stlemur (talk) 16:24, 2 August 2008 (UTC)

Hippocampal sclerosis and gluten sensitivity

Interesting study at PMID 19244266 : association (7 of 16 folks with TLE+HS were gluten sensitive, none in the TLE-alone and control groups). --CopperKettle 09:41, 19 March 2009 (UTC)

Hey Copper, When I first saw your post, my first thought was "small sample statistics, watch out", but having read the abstract, that cites similar pathology in other cases of gluten sensitivity, I am a little more open to this possibly being a factor. I would still want to flag the small sample size, but given that there may be a clear mechanistic explanation here, it might be worth adding something about this. Cheers, Edhubbard (talk) 17:14, 19 March 2009 (UTC)

Thanks for the reply! I also wonder - whether the Mesial temporal sclerosis is different from hippocampal sclerosis. --CopperKettle 03:45, 21 March 2009 (UTC)

It is said here that the two terms are used more or less synonymously despite describing a bit different damage areas. --CopperKettle 05:14, 21 March 2009 (UTC)

Hormones

Temporal lobe epilepsy and hormones... estrogen and progesterone are mentioned. Fine. What about other hormones? What about testosterone? This section of the article is quite scant and needs more. 75.48.31.123 (talk) 00:35, 15 August 2011 (UTC)

Eve LaPlante's "Seized" as a source

Eve Laplante's "Seized" should not be used as a credible source. It is non-medical and anecdotal. It has been controversial and heavily marketed since its release. I recommend removing the entire "arts" section from the article.

http://www.nejm.org/doi/full/10.1056/NEJM199405193302016

"Much of the book focuses on providing support for the concept of an epileptic personality. Among others, the late Norman Geschwind felt that there was an association between epilepsy and specific personality traits. In patients with temporal-lobe epilepsy, this epileptic personality is said to include such characteristics as hypergraphia, viscosity (tendency to repetition), religiosity, aggression, and altered sexuality. Although some people with temporal-lobe epilepsy may possess some of these traits, the concept of a typical epileptic personality is very controversial and has been refuted by a number of studies.

"The book includes interesting historical vignettes -- some brief, some more extensive -- detailing the lives of various artists and authors thought to have had epilepsy. Vincent van Gogh, Fyodor Dostoevsky, Gustave Flaubert, and Edgar Allan Poe are among those discussed as having had epilepsy. To support the hypothesis that temporal-lobe epilepsy produces a broad range of manifestations, many of the characteristics of these artists are attributed to their epilepsy. In the case of van Gogh, LaPlante would have us believe that his creative genius as well as his dysphoria resulted from, rather than coexisted with, his epilepsy. In fact, it is thought that van Gogh did have epilepsy but also suffered from alcohol abuse, periodic digitalis toxicity, and a major affective disorder. Each of these disorders may have contributed to and provided insights for his art, but it is unlikely that any of them actually produced his genius."

Lenny da Hog (talk) 22:38, 6 August 2012 (UTC)

The "Causes" section needs a summary sentence

It's not clear to me whether the causes are well understood, well understood for some types, or what. Thanks -- Jo3sampl (talk) 14:50, 24 September 2012 (UTC)

Copyedit

A little work on lead for readability. No change in content. Myrtlegroggins (talk) 10:12, 30 January 2014 (UTC) Hi there, I'm still working on the article to address the concerns above. I think it's (slowly) coming together. Let me know what you think :-) Kind regards and best in the New Year to all, Myrtle. Myrtlegroggins (talk) 22:08, 1 February 2014 (UTC)

references

User:Permstrump|—PermStrump: not sure about this ref [1] per MEDRS[2]--Ozzie10aaaa (talk) 11:12, 24 August 2016 (UTC)

Ozzie10aaaa Yeah, I wasn't totally sure about that one either. It was just so plainly worded that it was too tempting. I will look for something better. 17:07, 24 August 2016 (UTC)

I have a bad memory. I think I used the Hopkins source to make sure I understood the NIH source, but the NIH source supported everything I had added anyway, so I just took out the Hopkins one. —PermStrump(talk) 20:04, 25 August 2016 (UTC)

thank you--Ozzie10aaaa (talk) 10:47, 3 September 2016 (UTC)

B class article suitable for university religion classes

As a college professor teaching courses in comparative religion for thirty years I can say that this TLE article is certainly relevant to any discussion of Paul's "road to Damascus" experience, as he himself describes it in his letters. (Not the description in Acts of the Apostles.) We don't have any similar historical information from Mohammed, so offering a diagnosis will remain impossible. The article is within the reach of Humanities students. That being said, any topic which proposes a purely secular understanding of religious experience as illness is highly controversial and will draw partisans from all camps. NPOV will be hard to achieve, but contributions should be encouraged. Profhum (talk) 18:58, 22 September 2016 (UTC)

Tag atop the article

Although I can appreciate in some context there being a tag atop the article reading "this article is written like a manual or guidebook", the nature of the topic can assist people. I have TLE and have been, to the chagrin of my family and others, in absolute (almost hysterical) denial about my condition for several years, until literally just weeks ago. I don't care if other readers think my condition negates NPOV on this issue. Basically, much of the topic matter out there is guidebook-like material or just generally informative in this manner (see the references). I really don't see why this article, or generally other Wiki. articles of this nature, should be otherwise. The article is well-referenced, benign, impartial, and clinically informative. Should the tag be removed? If not, note the date on it and the fact the vast majority of talk page info. chronologically dates before Aug. 2015. Maybe a proposed discussion how to remove the tag would be appropriate?--Kieronoldham (talk) 01:48, 27 March 2017 (UTC)

@Kieronoldham: it was placed there at 26 august 2015, by AmericanLeMans; maybe he can give an explanation. Personally, I don't mind removing it. Joshua Jonathan -Let's talk! 01:58, 27 March 2017 (UTC)

PS: wish you all the best. Knowing one's limits makes life a little bit easier. Not perfect, unfortunately, but alas, nobody's alone in that respect. Joshua Jonathan -Let's talk! 02:03, 27 March 2017 (UTC)

Thanks, Joshua Jonathan. Thanks for the words. I was just about to buy a Vauxhall Corsa when I had the 1st grand mal and partly bit through my tongue. Won't go into detail, but I went into a state of extreme denial until an episode at my workplace on 23 Feb. and a few instances since then. Anyhow I'll ask AmericanLeMans. ;) I don't usually work on this topic matter but if there are a few proposals as to how he'd warrant removal I'll give it a go.--Kieronoldham (talk) 02:12, 27 March 2017 (UTC)

From a scholarly point of view, at least for some psychologists of religion, TLE is a fascinating condition. Though that won't make up for injured tongues, of course, nor the emotional struggles to cope with it. Joshua Jonathan -Let's talk! 02:25, 27 March 2017 (UTC)

Just added a message on AmericanLeMans's talk page. Thanks again, Joshua. K.S.--Kieronoldham (talk) 02:41, 27 March 2017 (UTC)--Kieronoldham (talk) 02:41, 27 March 2017 (UTC)

Effects on Society

TLE's effects being the cause for (alleged) visions by religious founders is probably more strongly supported by this page than anywhere else on the net. Deeper research into these founders alleged visions would greatly diminish the likelihood of a connection existing. There is much stronger evidence that supports these visions being completely fabricated by those claiming to have had them. Especially so in the case of Joseph Smith, neither of the 2 most comprehensive biographies ("No Man knows my history" & "Rough Stone Rolling") have evidence for TLE. The person claiming to have had a vision of god (during an EEG) quotes something that has been said countless times in sermons, and is written in various religious texts innumerably. Looks like the floor dropped out from under that parallel huh? I have TLE and while the condition is unique to each person. I certainly come out of a seizure feeling like garbage with any hallucinatory manifestations being remembered as bad dreams. The visions as they're described sound more like the result of a benzodiazepine withdrawal. js. — Preceding unsigned comment added by AllThingsNew (talk • contribs) 09:15, 28 October 2021 (UTC)

Wikipedia Ambassador Program course assignment

This article is the subject of an educational assignment at Youngstown State University supported by the Wikipedia Ambassador Program during the 2012 Q3 term. Further details are available on the course page.

The above message was substituted from {{WAP assignment}} by PrimeBOT (talk) on 15:57, 2 January 2023 (UTC)

VNS is a surgical treatment that does not stimulate the brain.

There is an error. 1) The VNS stimulates the vagus nerve, not the brain, 2) The VNS is not an alternative to surgery, the VNS is a type of surgery. I propose changing this statement:

Another treatment option is electrical stimulation of the brain through an implanted device called the vagus nerve stimulator (VNS).

To this statement:

A treatment option is electrical stimulation of the vagus nerve through an implanted device called the vagus nerve stimulator (VNS).

Thanks

TMM53 (talk) 17:54, 18 April 2023 (UTC) TMM53 (talk) 17:54, 18 April 2023 (UTC)

Electroencephalogram and physical exam and unknown cause

This statement is incomplete because physical exam and EEG are very important for diagnosis. The sentence confuses onset with cause.

TLE is diagnosed by taking a medical history, blood tests, and brain imaging. It can have a number of causes such as head injury, stroke, brain infections, structural lesions in the brain, brain tumors, or it can be of unknown onset.

Proposed change:

TLE is diagnosed by conducting a medical history, physical exam, blood tests, electroencephalogram and brain imaging. It can have a number of causes such as head injury, stroke, brain infections, structural lesions in the brain, brain tumors, or it can be of unknown cause.

TMM53 (talk) 22:56, 18 April 2023 (UTC)

Dangerous content removed

I removed the content below because this is dangerous.

First-aid is only required if there has been an injury or if this is the first time a person has had a seizure.

This statement is incorrect because first aid is needed if the seizure is prolonged and does not stop within 5 minutes. There may also be other reasons why first aid is needed. I placed a source for first aid from a reputable source.

TMM53 (talk) 01:28, 19 April 2023 (UTC)

Unsourced material should be removed as sources difficult to find.

I do not know where this content comes from and cannot find sources for these statements despite a significant effort. This unsourced content should be removed; these are examples:

People who experience only focal aware seizures may not recognize what they are, nor seek medical care.

They may include autonomic and psychic features present in focal aware seizures

The word grand mal comes from the French term, meaning major affliction.

The effect of temporal lobe epilepsy on personality is a historical observation dating to the 1800s. Personality and behavioral change in temporal lobe epilepsy is seen as a chronic condition when it persists for more than three months.

TMM53 (talk) 05:37, 19 April 2023 (UTC)

Unclear and incorrect items

This is a false statement and should be removed. Memory is not inside any anatomical structure. Memory function relies on a network of anatomical structures;the dentate gyrus may be an important node of this network.

Declarative memory (memories which can be consciously recalled) is formed in the area of the hippocampus called the dentate gyrus

This is a better statement:

Declarative memory (memories which can be consciously recalled) relies on the hippocampus.

This statement is difficult to understand and should be replaced.

Although the theory is controversial, there is a link between febrile seizures (seizures coinciding with episodes of fever in young children) and subsequent temporal lobe epilepsy, at least epidemiologically.[24][25][26][27]

This is a better statement:

A febrile seizure may increase the risk for developing epilepsy, including temporal lobe epilepsy; the risks for developing epilepsy are 0.5% (no febrile seizure), 1-2% (simple febrile seizure), 6%-8% (complex febrile seizure) and 14% (febrile status epilepticus). It is unclear if severe febrile seizures injure the brain leading to epilepsy, or if some children have an intrinsic brain abnormality that predisposes to both febrile seizures and epilepsy.

TMM53 (talk) 05:41, 19 April 2023 (UTC)

Incorrect statement

The section on "Surgical interventions" and "other treatments" is incorrect because other treatments are actually surgeries. "Scientifically sound" is incorrect; the Wiebe study was important because it was a controlled study. The issue is memory loss, not cognitive function. Experimental anticonvulsant treatment should be distinguished from other treatments because experimental treatment, unlike the other treatments, has uncertain effectiveness and possible severe unknown risks. The correction is:

Surgical interventions

Epilepsy surgery has been performed since the 1860s and doctors have observed that it is highly effective in producing freedom from seizures. However, it was not until 2001 that a controlled study demonstrated the effectiveness of anterior temporal lobectomy. Anterior temporal lobectomy may worsen memory. However, after anterior temporal lobectomy, memory function is supported by the opposite temporal lobe and recruitment of the frontal lobe. Cognitive rehabilitation may also help. Other surgical treatments include the vagus nerve stimulator, responsive neurostimulation device, anterior thalamic nucleus stimulator, stereotactic radiosurgery and laser ablation.

Other treatments

The ketogenic diet and modified Atkins diet are additional options. Those who have uncontrolled seizures may contribute to improving epilepsy care by participating in experimental drug studies.

TMM53 (talk) 05:42, 19 April 2023 (UTC) TMM53 (talk) 05:42, 19 April 2023 (UTC)

Content conflicts with guideline.

Most of this content below does not conform to Wikipedia policy and should be removed. This content can be placed in V. S. Ramachandran. Some content is already on Neuroscience of religion so it is redundant. The content is preserved in the Talk page. If you do not agree, please read the following and it will be obvious why most of the content does not belong:

• Wikipedia:Fringe theories
• Wikipedia:Scientific, academic, mainstream, and proportional point of view
• Wikipedia:Wikipedia is a mainstream encyclopedia
• Wikipedia:Manual of Style/Medicine-related articles
• Wikipedia:Verifiability

This is the current content:

Effects on society

The first to record and catalog the abnormal symptoms and signs of TLE was Norman Geschwind. He found a constellation of symptoms that included hypergraphia, hyperreligiosity, collapse, and pedantism, now called Geschwind syndrome.

Vilayanur S. Ramachandran explored the neural basis of the hyperreligiosity seen in TLE using the galvanic skin response (GSR), which correlates with emotional arousal, to determine whether the hyperreligiosity seen in TLE was due to an overall heightened emotional state or was specific to religious stimuli. Ramachandran presented two subjects with neutral, sexually arousing and religious words while measuring GSR. Ramachandran was able to show that patients with TLE showed enhanced emotional responses to the religious words, diminished responses to the sexually charged words, and normal responses to the neutral words. This study was presented as an abstract at a neuroscience conference and referenced in Ramachandran's book, Phantoms in the Brain, but it has never been published in the peer-reviewed scientific press.

A study in 2015, reported that intrinsic religiosity and religiosity outside of organized religion were higher in patients with epilepsy than in the control group. Lower education level, abnormal background EEG activity, and hippocampal sclerosis have been found to be contributing factors for religiosity in TLE.

TLE has been suggested as a materialistic explanation for the revelatory experiences of prominent religious figures such as Abraham, Moses, Jesus, Mohammed, Saint Paul, Joan of Arc, Saint Teresa of Ávila, and Joseph Smith. These experiences are described (in possibly unreliable accounts) as complex interactions with their visions; but possibly (and dependent on the reliability of historical accounts, often made by acolytes) lack the stereotypy, amnestic periods, and automatisms or generalized motor events, which are characteristic of TLE. Psychiatric conditions with psychotic spectrum symptoms might be more plausible physical explanation of these experiences. It has been suggested that Pope Pius IX's doctrine of the immaculate conception was influenced by his forensically diagnosed partial epilepsy.

In 2016, a case history found that a male temporal lobe epileptic patient experienced a vision of God following a temporal lobe seizure, while undergoing EEG monitoring. The patient reported that God had sent him to the world to "bring redemption to the people of Israel". The purported link between TLE and religiosity has inspired work by Michael Persinger and other researchers in the field of neurotheology. Others have questioned the evidence for a link between temporal lobe epilepsy and religiosity.

This is the proposed revision which will can be placed in Personality section adjacent to Geshwind content:

Other studies have investigated the relationship between religion and epilepsy.

References

TMM53 (talk) 06:56, 19 April 2023 (UTC)

Pathophysiology section uses primary sources, outdated information, needs rewrite.

The pathophysiology section is based all on primary sources which is not recommended for medical articles Wikipedia:Identifying reliable sources (medicine). Some of the mechanisms have been shown to be invalid e.g. dormant basket cell and granule cell dispersion. Also, Human herpes virus 6 and Reelin have very limited evidence for being significant and should not be included. I will rewrite using secondary sources and retain as much as possible. Any thoughts, then please respond.

Dormant basket cell not considered valid:

• Ben-Ari, Yehezkel; Dudek, F. Edward (September 2010). "Primary and Secondary Mechanisms of Epileptogenesis in the Temporal Lobe: There is a before and an After". Epilepsy Currents. 10 (5): 118–125. doi:10.1111/j.1535-7511.2010.01376.x. ISSN 1535-7597.

Granule cell dispersion occurs in many people without epilepsy:

• Roy, Achira; Millen, Kathleen J.; Kapur, Raj P. (2020). "Hippocampal granule cell dispersion: a non-specific finding in pediatric patients with no history of seizures". Acta Neuropathologica Communications. 8 (1): 54. doi:10.1186/s40478-020-00928-3.{{cite journal}}: CS1 maint: unflagged free DOI (link)

TMM53 (talk) 06:23, 5 June 2023 (UTC)