López-Amador Noé, Castro-Morales Rosario, Denis-Rodríguez Patricia, Carvajal-Zarrabal Octavio
Department of Clinical and Forensic Neuroscience, University of Veracruz, Boca del Río, MEX.
Master's Degree Program in Forensic Medicine (National Postgraduate System-National Council for Humanities, Sciences, and Technologies), University of Veracruz, Boca del Río, MEX.
Cureus. 2024 Dec 24;16(12):e76310. doi: 10.7759/cureus.76310. eCollection 2024 Dec.
Temporal lobe epilepsy (TLE) represents a prevalent form of focal epilepsy that often requires surgical intervention and can be resistant to antiseizure medications. Its epidemiology varies across regions due to diagnostic challenges and underestimation of individual neurological traits. Despite these complexities, TLE accounts for a significant proportion of total epilepsies worldwide. Early discussions on TLE's forensic implications date back to the mid-20th century, highlighting its unique behavioral and mental disturbances during seizures. The International League Against Epilepsy categorizes seizures based on type and onset, aiding in diagnosis and treatment planning. Neuroimaging techniques play a crucial role in identifying the epileptogenic focus within the temporal lobe. TLE's etiology involves various risk factors, including genetic predisposition and neurological insults. Clinically, TLE presents diverse signs and symptoms across different phases. This literature review explores the forensic implications of TLE, including legal responsibility, sudden death, and its association with criminal behavior. It examines the challenges in diagnosing TLE in court and discusses the complex interplay between TLE, psychosis, and substance use in determining legal liability. Furthermore, it addresses the risk of sudden unexpected death in epilepsy (SUDEP) and sudden unexplained death in childhood (SUDC) associated with TLE. Finally, the review underscores the need for further research to comprehensively understand TLE's forensic and medicolegal implications, considering its intricate neurobiological underpinnings and clinical manifestations.
颞叶癫痫（TLE）是一种常见的局灶性癫痫，通常需要手术干预，并且可能对抗癫痫药物耐药。由于诊断挑战和对个体神经特征的低估，其流行病学在不同地区有所差异。尽管存在这些复杂性，但TLE在全球癫痫总数中占相当大的比例。关于TLE法医意义的早期讨论可追溯到20世纪中叶，强调了其在发作期间独特的行为和精神障碍。国际抗癫痫联盟根据类型和发作情况对癫痫发作进行分类，有助于诊断和治疗规划。神经影像学技术在确定颞叶内的致痫灶方面起着关键作用。TLE的病因涉及多种风险因素，包括遗传易感性和神经损伤。临床上，TLE在不同阶段表现出多样的体征和症状。这篇文献综述探讨了TLE的法医意义，包括法律责任、猝死及其与犯罪行为的关联。它审视了在法庭上诊断TLE的挑战，并讨论了在确定法律责任时TLE、精神病和物质使用之间复杂的相互作用。此外，它还探讨了与TLE相关的癫痫猝死（SUDEP）和儿童不明原因猝死（SUDC）的风险。最后，该综述强调需要进一步研究，以全面了解TLE的法医和法医学意义，同时考虑其复杂的神经生物学基础和临床表现。
