TITLE:
Focal Temporal Lobe Seizures with Preserved Consciousness Revealed by Psychiatric Manifestations: A Case Study
AUTHORS:
Fatima Zahra Berrada, Houyam Tibar, Fatiha Lahjouji, Hajar Naciri, Dahab Ouhabi, Ali Benomar, Wafa Regragui
KEYWORDS:
Temporal Epilepsy, Hallucination, Psychiatric Manifestations, ILAE 2025, Focal Seizures
JOURNAL NAME:
Open Access Library Journal,
Vol.12 No.9,
September
9,
2025
ABSTRACT: Temporal lobe epilepsy is the most common form of focal epilepsy, which can primarily present through psychiatric manifestations. We present the case of a 49-year-old female patient who developed psychosensory symptoms, with a history of left lateral sinus venous thrombosis leading to temporal infarction and intermittent tinnitus as a sequela. One year ago, she began experiencing paroxysmal, elaborate visual and auditory hallucinations associated with mood disturbances. The patient initially consulted a psychiatrist with no clinical improvement. The diagnosis of lateral temporal epilepsy was only established after the patient progressed from simple auditory hallucinations to ictal aphasia with complex auditory and visual auras, confirmed in a second EEG. This case highlights that paroxysmal psychiatric manifestations should raise suspicion of temporal lobe epilepsy, especially when the patient’s age does not fit the typical presentation pattern observed in the classical nosology of psychotic disorders.