Temporal Lobe Seizure: Complete Guide to Symptoms, Auras, Causes, Diagnosis, and Treatment
Updated: 50 minutes ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
TL;DR
A temporal lobe seizure (also called a focal seizure with impaired awareness) begins in the brain's temporal lobes, which process emotions and short-term memory. It often starts with a warning feeling called an aura — deja vu, a strange odor or taste, or a rising feeling in the belly — followed by staring, lip smacking, and picking motions that most often last 30 seconds to 2 minutes. The cause often isn't known but may stem from a scar in the hippocampus. Treatment usually starts with anti-seizure medicine, with surgery or nerve-stimulation devices for those who don't respond.
Quick Answer: What Is a Temporal Lobe Seizure?
A temporal lobe seizure is a seizure that begins in the temporal lobes of the brain, the areas that process emotions and are important for short-term memory. It is sometimes called a focal seizure with impaired awareness. During the seizure, the person may look awake but will not respond to what is around them, and their lips and hands may repeat motions such as lip smacking or picking. These seizures most often last 30 seconds to 2 minutes and are usually treated with medicine, with surgery as an option for those who don't respond.
What Is a Temporal Lobe Seizure?
Temporal lobe seizures begin in the temporal lobes of the brain. These areas process emotions and are important for short-term memory. Symptoms of a temporal lobe seizure often affect these functions. Some people have odd feelings during the seizure, such as joy, deja vu, or fear.
Temporal lobe seizures are sometimes called focal seizures with impaired awareness. Some people are aware of what's going on during the seizure. People who have more-intense seizures might look awake but won't respond to what's around them. Their lips and hands may make motions over and over.
The cause of temporal lobe seizures often isn't known. But it may stem from a scar in the temporal lobe. Temporal lobe seizures are treated with medicine. Some people who don't respond to medicine may have surgery.
Each side of the brain contains four lobes. The frontal lobe is important for cognitive functions and voluntary movement or activity. The parietal lobe processes information about temperature, taste, touch, and movement. The occipital lobe is primarily responsible for vision. The temporal lobe processes memories, integrating them with sensations of taste, sound, sight, and touch.
During waking and sleeping, the brain cells have electrical activity. A burst of electrical activity in many brain cells may cause a seizure. If this burst happens in just one area of the brain, the result is a focal seizure. A temporal lobe seizure is a focal seizure that starts in one of the temporal lobes.
Key Fact | Detail |
Where it starts | The temporal lobes, which process emotions and short-term memory |
Also called | Focal seizure with impaired awareness |
Typical duration | Most often 30 seconds to 2 minutes |
Awareness | Some people remain aware; others look awake but don't respond |
Usual cause | Often not known; may stem from a scar in the temporal lobe |
First treatment | Medicine; surgery for some who don't respond |
The Warning Sign: Auras
An odd feeling called an aura may happen before a temporal lobe seizure. An aura acts as a warning. Not everyone who has temporal lobe seizures has auras, and not everyone who has auras remembers them. The aura is the first part of a focal seizure before a loss of consciousness.
Examples of auras include a sudden sense of fear or joy and a feeling that what's happening has happened before, known as deja vu. A sudden or strange odor or taste can occur, as can a rising feeling in the belly that feels like being on a roller coaster.
Aura (Warning) | Description |
Sudden fear or joy | An abrupt, unexplained emotional shift |
Deja vu | A feeling that what's happening has happened before |
Strange odor or taste | A sudden or unusual smell or flavor |
Rising belly feeling | A sensation in the belly like being on a roller coaster |
What Happens During the Seizure
Sometimes temporal lobe seizures keep people from responding to others. This type of temporal lobe seizure most often lasts 30 seconds to 2 minutes. Symptoms of a temporal lobe seizure include not being aware of the people and things around you, staring, lip smacking, swallowing or chewing over and over, and finger movements such as picking motions.
What Happens After the Seizure
After a temporal lobe seizure, you may be confused and have trouble speaking for a time. You may be unable to recall what happened during the seizure, unaware of having had a seizure, or very sleepy.
Sometimes, what starts as a temporal lobe seizure becomes a generalized tonic-clonic seizure. This type of seizure causes shaking, known as convulsions, and loss of consciousness. It also is called a grand mal seizure.
Phase | What Happens |
Aura (warning) | Sudden fear or joy, deja vu, strange odor or taste, rising feeling in the belly |
During (30 seconds to 2 minutes) | Unaware of surroundings, staring, lip smacking, chewing or swallowing over and over, finger picking motions |
After | Confusion, trouble speaking, no memory of the seizure, unaware it happened, very sleepy |
Possible spread | May become a generalized tonic-clonic (grand mal) seizure with convulsions and loss of consciousness |
When to Get Emergency Help
Call 911 or your local emergency number if the seizure lasts more than five minutes, breathing or consciousness doesn't return after the seizure stops, a second seizure follows right away, recovery isn't complete after the seizure, recovery is slower than usual, you're pregnant, you have diabetes, or an injury happens during the seizure.
For a first seizure, see a healthcare professional. Seek medical advice if you think you or your child has had a seizure, if you have more seizures or more-intense seizures, or if you have new seizure symptoms.
What Causes a Temporal Lobe Seizure?
Often, experts don't know the cause of temporal lobe seizures. But they can result from several factors. Traumatic brain injury can cause them, as can infections such as encephalitis and meningitis or a history of such infections. A process that causes scarring in a part of the temporal lobes called the hippocampus — known as gliosis — is one possible source.
Other causes include blood vessels in the brain that aren't formed correctly, called vascular malformations, as well as stroke, brain tumors, genetic syndromes, and withdrawal from alcohol overuse.
Possible Cause | Description |
Often unknown | Experts often don't know the cause |
Traumatic brain injury | Injury to the brain |
Infections | Encephalitis and meningitis, or a history of such infections |
Hippocampal scarring (gliosis) | Scarring in part of the temporal lobes called the hippocampus |
Vascular malformations | Blood vessels in the brain that aren't formed correctly |
Stroke | Blood flow disruption in the brain |
Brain tumors | Growth in the brain |
Genetic syndromes | Inherited conditions |
Alcohol withdrawal | Withdrawal from alcohol overuse |
Risk Factors
There are several risk factors for temporal lobe seizures, and they pose the most risk if they happen early in life. These risk factors include brain injury, infections such as encephalitis or meningitis, and a seizure caused by a fever, called a febrile seizure.
Risk Factor | Note |
Brain injury | Injury to the brain |
Infections | Encephalitis or meningitis |
Febrile seizure | A seizure caused by a fever |
Timing matters | These factors pose the most risk if they happen early in life |
Complications
Over time, repeated temporal lobe seizures can cause the part of the brain involved in learning and memory to shrink. This area of the brain is called the hippocampus. The loss of brain cells in the hippocampus may cause memory problems.
How Is a Temporal Lobe Seizure Diagnosed?
After a seizure, your healthcare professional reviews your symptoms and medical history. You may have tests to find the cause of your seizure. Knowing the cause helps show how likely it is that you'll have another seizure.
A neurological exam tests your behavior, motor abilities, and mental function, which can show how well your brain and nervous system are working. A blood sample goes to a lab to check for signs of infection, genetic conditions, blood sugar levels, and electrolyte imbalances.
An electroencephalogram, also called an EEG, uses flat metal discs called electrodes attached to your scalp to record the electrical activity of your brain, which shows up as wavy lines on an EEG recording. The EEG may show a pattern that tells whether a seizure is likely to happen again and can help rule out other conditions that look like epilepsy. A high-density EEG test places electrodes close together on the scalp and can help find the area in the brain where seizures happen.
A CT scan uses X-rays to get cross-sectional images of the brain and can show tumors, bleeding, and cysts. An MRI uses powerful magnets and radio waves to show a detailed view of the brain and possible causes of seizures.
A PET scan uses a small amount of low-dose radioactive material placed into a vein to show active areas of the brain, revealing where in the brain the seizure began. A SPECT test uses a small amount of low-dose radioactive tracer to make a detailed, 3D map of the blood flow in the brain during a seizure. A form of a SPECT test called subtraction ictal SPECT coregistered with magnetic resonance imaging, also called SISCOM, may give even more-detailed results.
Diagnostic Test | What It Checks |
Neurological exam | Behavior, motor abilities, and mental function |
Blood tests | Signs of infection, genetic conditions, blood sugar, electrolyte imbalances |
EEG | Electrodes on the scalp record brain electrical activity; may show a pattern predicting another seizure |
High-density EEG | Electrodes placed close together to locate where seizures happen |
CT scan | X-ray cross-sections showing tumors, bleeding, and cysts |
MRI | Detailed view of brain structure and possible causes |
PET | Shows active brain areas to locate where the seizure began |
SPECT / SISCOM | 3D map of blood flow during a seizure, with SISCOM providing more-detailed results |
Treatment Options
Not everyone who has a seizure has another one. Your healthcare professional may decide not to start treatment until you've had more than one. Seizure treatment aims to find the best therapy to stop your seizures with the fewest side effects.
Medications
Many medicines treat temporal lobe seizures. But many people can't manage seizures fully with medicines alone. Side effects are common; they can include tiredness, weight gain, and dizziness.
Discuss possible side effects with your healthcare professional when thinking about treatments. Also ask what effect your seizure medicines may have on other medicines you take. For instance, some antiseizure medicines can affect how well birth control pills work.
Dietary Therapy
Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates, but it can be hard to follow because it allows only a very limited number of foods. Other versions of a high-fat, low-carbohydrate diet also may be helpful but not work as well. These diets include low glycemic index and Atkins diets. Experts are still studying these diets.
Surgery and Other Procedures
When antiseizure medicines don't work, there are other treatments.
Surgery. Epilepsy surgery is a procedure to reduce seizures and improve the quality of life of people who have epilepsy. Surgeons often do this with open surgery to remove the area of the brain where seizures begin. Sometimes, surgeons may be able to use MRI-guided laser therapy — a less-invasive way to destroy the area of tissue that causes seizures.
Surgery works best if you have seizures that always start in the same place in the brain. Most often, you won't have surgery if your seizures come from more than one area of the brain. You also might not be able to have surgery if your healthcare team can't find where the seizures start. Surgery also may not be an option if your seizures come from a part of the brain that affects speech, thinking, movement, memories, and other important functions.
Vagus nerve stimulation. A device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures.
Responsive neurostimulation. Surgeons place a device on the brain or in brain tissue. The device can tell when seizure activity starts and sends electrical stimulation to stop the seizure.
Deep brain stimulation. Surgeons place thin wires called electrodes in certain areas of the brain to produce electrical impulses. The impulses help the body manage the brain activity that causes seizures. The electrodes attach to a pacemaker-like device placed under the skin of the chest. The device manages how much stimulation happens.
Treatment | How It Works | Notes |
Anti-seizure medicines | Daily medicines to stop seizures | Side effects common: tiredness, weight gain, dizziness; many can't be fully controlled by medicines alone |
Surgery | Open surgery removes the area where seizures begin | Works best when seizures always start in the same place |
MRI-guided laser therapy | Less-invasive way to destroy seizure-causing tissue | An alternative surgical option |
Vagus nerve stimulation | Chest device stimulates the vagus nerve in the neck, lessening seizures | For when medicines don't work |
Responsive neurostimulation | Device on or in the brain detects seizure activity and stops it | For when medicines don't work |
Deep brain stimulation | Electrodes in the brain produce impulses that manage seizure-causing activity, controlled by a chest device | For when medicines don't work |
Dietary therapy | Ketogenic diet (high fat, very low carbs) improves seizure management; low glycemic index and Atkins diets are variations | Hard to follow; still being studied |
Lifestyle and Home Care
Here are some steps you can take to help manage seizures. Take medicine correctly — don't change the dose without first talking with your healthcare professional. Get enough sleep, since lack of sleep can trigger seizures; be sure to get enough rest every night. Wear a medical alert bracelet to help emergency responders know how to treat you if you have a seizure. Ask your healthcare professional about driving; people who have seizures must be seizure-free for a certain length of time before being able to drive, and the amount of time varies by state.
Personal Safety
Most often, seizures don't result in serious injury, but injury is possible if you have recurrent seizures. Take care near water: don't swim alone or ride in a boat without someone nearby. Wear a helmet during activities such as bike riding or playing sports. Take showers rather than baths unless someone is near you. Soften your home by padding sharp corners, buying furniture with rounded edges, choosing chairs with arms to keep you from falling off, and thinking about having carpet with thick padding to protect you if you fall. Have a list of seizure first-aid tips in a place where people can see them, including phone numbers that people might need if you have a seizure.
Seizure First Aid
It's helpful to know what to do if you see someone having a seizure. If you're at risk of having seizures in the future, give this information to family, friends, and co-workers. To help someone during a seizure, carefully roll the person onto one side, place something soft under the person's head, and loosen tight neckwear. Don't put your fingers or other objects in the person's mouth, and don't try to restrain the person. Clear away dangerous objects if the person is moving. Stay with the person until medical help arrives, watch the person closely so that you can tell medical helpers what happened, time the seizure, and stay calm.
Coping and Support
Stress due to living with a seizure condition can affect your mental health, so talk with your healthcare professional about your feelings and look for ways to find help. Your family can provide much-needed support — tell them what you know about your seizures and let them ask questions. At work, talk with your supervisor about your seizures and how they affect you, and discuss what your co-workers should do if you have a seizure at work. Reach out to family and friends, ask your healthcare professional about local support groups, or join an online support community. Having a strong support system is vital to living with any medical condition.
Pregnancy and Seizures
People who've had seizures can most often have healthy pregnancies. But some medicines used to treat seizures sometimes can cause health conditions that are present at birth. Valproic acid is a medicine for generalized seizures that has been linked with cognitive issues and neural tube defects, such as spina bifida, in babies. The American Academy of Neurology recommends against using valproic acid during pregnancy because of risks to babies.
Talk with your healthcare professional about the risks of antiseizure medicines, including the risk of health conditions present at birth. Make a plan with your health professional before you get pregnant, since pregnancy can change the way you need to take your medicine. Some people may need to change the dosage of seizure medicine before or during pregnancy. The goal is to be on the lowest dose of the safest seizure medicine that manages seizures.
Some antiseizure medicines keep birth control from working as well. Check with your healthcare professional to see whether your medicine affects your birth control; you may need to try other forms of birth control.
Preparing for Your Appointment
Sometimes seizures need medical help right away, and there isn't always time to prepare for an appointment. But you may see your main healthcare professional or be sent to a specialist — a doctor trained in brain and nervous system conditions, called a neurologist, or a neurologist trained in epilepsy, known as an epileptologist.
To prepare, write down what you remember about the seizure, including when and where it happened, the symptoms you had, and how long it lasted, if you know. Ask anyone who saw the seizure to help fill in the details. Be aware of any restrictions before your appointment. Write down key personal information, including any major stresses or recent life changes. Make a list of all medicines, vitamins, or supplements you take, including doses. Take a family member or friend to your appointment — someone who goes with you may be able to answer questions about your seizure that you can't. Write down questions to ask your healthcare professional.
Questions to Ask Your Doctor |
What do you think caused my seizure? |
What tests do I need? |
What treatment do you suggest? |
How likely is it that I might have another seizure? |
How can I make sure that I don't hurt myself if I have another seizure? |
I have other health conditions — how can I best manage them together? |
Are there restrictions that I need to follow? |
Are there brochures or other printed material that I can have? What websites do you suggest? |
Your healthcare professional is likely to ask questions too. Be ready to describe your seizure episode, whether anyone was there to see what happened, and what you felt just before and right after the seizure. Be prepared to discuss whether you have had a seizure or other neurological condition in the past, whether any family members have been diagnosed with a seizure condition or epilepsy, and whether you have recently traveled outside the country.
Conclusion
A temporal lobe seizure begins in the brain's temporal lobes, where emotions and short-term memory are processed. It often announces itself with an aura — deja vu, a sudden emotion, a strange smell or taste, or a rising feeling in the belly — before brief staring, lip smacking, and picking motions take over for 30 seconds to 2 minutes. The cause often isn't known, but infections, injuries, and scarring in the hippocampus are among the possibilities. EEG recordings and brain imaging help doctors locate the seizure's starting point, and daily anti-seizure medicine controls many people's seizures. When medicines fall short, surgery (sometimes with MRI-guided laser therapy), nerve-stimulation devices, and dietary therapy offer real alternatives. Protect yourself with first-aid planning, good sleep, and safety adjustments at home, and always check in with a healthcare professional about a first seizure or any change in your pattern.
Take the next step: If you or someone you know may have had a seizure, see a healthcare professional.
Frequently Asked Questions
What is a temporal lobe seizure?
A temporal lobe seizure is a seizure that begins in the temporal lobes of the brain, which process emotions and short-term memory. It is sometimes called a focal seizure with impaired awareness, because the person may look awake but not respond to what is around them.
What does a temporal lobe seizure feel like before it happens?
An odd feeling called an aura may act as a warning. Auras can include a sudden sense of fear or joy, deja vu, a sudden or strange odor or taste, or a rising feeling in the belly like being on a roller coaster. Not everyone has auras, and not everyone remembers them.
What does a temporal lobe seizure look like?
Symptoms include not being aware of the people and things around you, staring, lip smacking, swallowing or chewing over and over, and finger movements such as picking motions. The seizure most often lasts 30 seconds to 2 minutes.
How long does a temporal lobe seizure last?
This type of temporal lobe seizure most often lasts 30 seconds to 2 minutes. Afterward, the person may be confused, have trouble speaking, have no memory of the seizure, or be very sleepy.
What causes temporal lobe seizures?
The cause often isn't known but may stem from a scar in the temporal lobe. Possible causes include traumatic brain injury, infections such as encephalitis and meningitis, scarring in the hippocampus (gliosis), vascular malformations, stroke, brain tumors, genetic syndromes, and withdrawal from alcohol overuse.
When should you call 911?
Call 911 or your local emergency number if the seizure lasts more than five minutes, breathing or consciousness doesn't return after it stops, a second seizure follows right away, recovery isn't complete or is slower than usual, the person is pregnant or has diabetes, or an injury happens during the seizure.
How are temporal lobe seizures treated?
Treatment usually involves anti-seizure medicines, though many people can't manage seizures fully with medicines alone. When medicines don't work, options include surgery (sometimes with MRI-guided laser therapy), vagus nerve stimulation, responsive neurostimulation, deep brain stimulation, and dietary therapy such as a ketogenic diet.
Can repeated temporal lobe seizures cause memory problems?
Yes. Over time, repeated temporal lobe seizures can cause the hippocampus — the part of the brain involved in learning and memory — to shrink, and the loss of brain cells there may cause memory problems.
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This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about any medical condition or treatment decision.
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