EEG findings would be compatible with partial complex seizure disorder. Since the feelings can arise de novo without any identifiable precipitant, an incorrect diagnosis of an acute panic attack may be entertained. Almost always, however, the patient will describe additional experiences that will help in the differential diagnosis. In an attempt to explain the experience, the patient will sweep his or her hands upward starting at the abdomen. Questions about specific epileptic experiences should be delayed until the end of the interview to avoid suggestibility.
Controversy continues as to the validity of a so-called temporal lobe personality.
When interviewing suspected TLE patients, it's important to inquire about their birth and any complications of the pregnancy. Forceps deliveries, now almost unheard of, were quite common years ago and led to compressive injuries of the brain, anoxic damage to Ammon's horn in the hippocampus and the subsequent temporal lobe epilepsy. Also ask about generalized seizures, head injuries, concussions, temper tantrums and, with males, a history of aggression, fire setting, truancy and impulsive behaviors. Often the patients are aware of their lapses, and almost all of them experience some form of memory disturbance, even if nothing more than a vague inability to grasp things with sufficient precision. Finally, the clinician should inquire as to a family history of migraine, since migraine is overrepresented in families with TLE and can mimic the majority of TLE symptoms.