Babinski signs were also elicitable bilaterally. The jaw-jerk reflex was normal. Also at this time, moderate disruption of touch and vibration sense could be detected in both legs. The tumor was in the temporal lobe on the right side, including many regions of the limbic system. The nightmares, like the hallucinations during waking periods, are consistent with location of the tumor in the limbic system.
Memory deficits point to involvement of the hippocampal formation.
The initial epileptic focus was in the olfactory structures of the temporal lobe including the amygdala and olfactory regions of the limbic cortex. The treatment performed was most likely a unilateral temporal lobectomy on the side of the epileptic focus. The contralateral medial temporal lobe was either severely damaged by the accident or removed in the second surgery, resulting in a bilateral temporal lobectomy. The oral tendencies, hypersexuality and decreased emotionality are most likely the result of damage to the amygdala. Damage to the hippocampus underlies the memory deficits, and visual association areas of the temporal cortex underlie the visual agnosia.