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Olfactory Auras in Patients with Temporal Lobe Epilepsy

  1. Chien Chen3,
  2. Yang-Hsin Shih1,
  3. Der-Jen Yen3,
  4. Jiing-Feng Lirng2,
  5. Yuh-Cherng Guo3,
  6. Hsiang-Yu Yu3,
  7. Chun-Hing Yiu3

Article first published online: 6 FEB 2003

DOI: 10.1046/j.1528-1157.2003.25902.x

Issue

Epilepsia

Epilepsia

Volume 44, Issue 2, pages 257–260, February 2003

Additional Information

How to Cite

Chen, C., Shih, Y.-H., Yen, D.-J., Lirng, J.-F., Guo, Y.-C., Yu, H.-Y. and Yiu, C.-H. (2003), Olfactory Auras in Patients with Temporal Lobe Epilepsy. Epilepsia, 44: 257–260. doi: 10.1046/j.1528-1157.2003.25902.x

Author Information

  1. 1

    Departments of Neurology,

  2. 2

    Neurosurgery, and

  3. 3

    Radiology, The Neurological Institute, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan

*Address corresponding and reprint requests to Dr. Der-Jen Yen at Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, 201, Sec. 2, Shih-pai Road, Shih-pai, Taipei, Taiwan 11217. E-mail: djyen@vghtpe.gov.tw

Publication History

  1. Issue published online: 6 FEB 2003
  2. Article first published online: 6 FEB 2003
  3. Accepted September 2, 2002.

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Keywords:

  • Aura;
  • Olfactory aura;
  • Olfactory hallucination;
  • Temporal lobe epilepsy;
  • Temporal lobectomy

Summary:  Purpose: To investigate olfactory auras in patients with temporal lobe epilepsy (TLE).

Methods: We reviewed medical records of 217 Chinese patients who underwent temporal lobectomy for medically intractable TLE between 1987 and 1998 in Taiwan. Patients with olfactory auras asked for detailed characteristics of their auras.

Results: In all, 12 (5.5%) patients had olfactory auras, seven men and five women. All patients except one described and characterized the unpleasant olfactory auras. Olfactory auras were usually combined with other auras, most frequently sensations of epigastric rising, nausea, and fear. Association with gustatory hallucination was uncommon, in only one patient. On neuroimaging study, 11 patients had structural lesions involving the mesial temporal structures, two exclusively involving the amygdala. Histologic diagnosis included gliosis of the mesial temporal regions in seven (58.3%) patients, neoplasm in four (33.3%) patients, and arteriovenous malformation in one patient. Postoperatively, eight patients were seizure free. Three patients had rare seizures; however, none reported residual olfactory auras.

Conclusions: Olfactory auras are infrequent in TLE. In this study, mesial temporal sclerosis is the most common etiology rather than tumors. Mesial temporal structures, especially the amygdala, may play important roles in the genesis of olfactory auras.

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