skip to main content

Focal temporal lobe epilepsy — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardEpilepsyFocal temporal lobe epilepsySCE Neurology

A rising epigastric sensation and fear are followed by behavioural arrest, lip-smacking and ten minutes of confusion. MRI shows left hippocampal sclerosis and EEG left anterior temporal sharp waves. Where do the seizures arise?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Left mesial temporal lobe, with neurological reassessment

The best answer is “Left mesial temporal lobe, with neurological reassessment”. The experiential aura, oroalimentary automatisms, postictal confusion, hippocampal sclerosis and concordant EEG all localise to the left mesial temporal network. “Left dorsolateral frontal cortex” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Right parietal association cortex” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Bilateral occipital cortex” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Right supplementary motor area” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here.

Reference: ILAE seizure classification position paper: https://pubmed.ncbi.nlm.nih.gov/28276060/