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Considerations of Secondary Temporalization

In generalized forms of epileptic seizure disorder, secondary focal involvement of the temporal lobe may gradually develop. Such signs of "secondary temporalization" may manifest themselves in the seizures type (occurrence of complex partial seizures) and in the EEG. Fourteen observations of secondary temporalization are reported: 3 of them in cases of primary generalized epilepsy and 11 in patients with Lennox-Gastaut syndrome. In 9 patients, additional depth implants were carried out in order to detect a primary focal epileptogenic lesion. Secondary temporalization is likely to be caused by independent paroxysmal activity evolving in the limbic structures (amygdala, hippocampus) due to their role of "low threshold areas." Postconvulsive hypoxic damage of the hippocampus is possible but a much less likely cause of secondary temporal lobe manifestations.