Auras
o Auras occur in approximately 80% of temporal lobe seizures. They are a common feature of simple partial seizures and usually precede complex partial seizures of temporal lobe origin.
o Auras may be classified by symptom type; the types comprise somatosensory, special sensory, autonomic, or psychic symptoms.
* Somatosensory and special sensory phenomena
o Olfactory and gustatory illusions and hallucinations may occur. Acharya et al found that olfactory auras are associated more commonly with temporal lobe tumors than with other causes of TLE.
o Auditory hallucinations consist of a buzzing sound, a voice or voices, or muffling of ambient sounds. This type of aura is more common with neocortical TLE than with other types of TLE.
o Patients may report distortions of shape, size, and distance of objects.
o These visual illusions are unlike the visual hallucinations associated with occipital lobe seizure in that no formed elementary visual image is noted, such as the visual image of a face that may be seen with seizures arising from the fusiform or the inferior temporal gyrus.
o Things may appear shrunken (micropsia) or larger (macropsia) than usual.
o Tilting of structures has been reported. Vertigo has been described with seizures in the posterior superior temporal gyrus.
* Psychic phenomena
o Patients may have a feeling of déjà vu or jamais vu, a sense of familiarity or unfamiliarity, respectively.
o Patients may experience depersonalization (ie, feeling of detachment from oneself) or derealization (ie, surroundings appear unreal).
o Fear or anxiety usually is associated with seizures arising from the amygdala. Sometimes, the fear is strong, described as an "impending sense of doom."
o Patients may describe a sense of dissociation or autoscopy, in which they report seeing their own body from outside.
* Autonomic phenomena are characterized by changes in heart rate, piloerection, and sweating. Patients may experience an epigastric "rising" sensation or nausea.
Physical
* Following the aura, a temporal lobe complex partial seizure begins with a wide-eyed, motionless stare, dilated pupils, and behavioral arrest. Oral alimentary automatisms such as lip smacking, chewing, and swallowing may be noted. Manual automatisms or unilateral dystonic posturing of a limb also may be observed.
* Patients may continue their ongoing motor activity or react to their surroundings in a semipurposeful manner (ie, reactive automatisms). They can have repetitive stereotyped manual automatisms.
* A complex partial seizure may evolve to a secondarily generalized tonic-clonic seizure. Often, the documentation of a seizure only notes the generalized tonic-clonic component of the seizure. A careful history from the patient or an observer is needed to elicit the partial features of either a simple seizure or a complex partial seizure before the secondarily generalized seizure is important.
* Patients usually experience a postictal period of confusion, which distinguishes TLE from absence seizures, which are not associated with postictal confusion. In addition, absence seizures are not associated with auras nor with complex automatisms. Postictal aphasia suggests onset in the language-dominant temporal lobe.
* Most auras and automatisms last a very short period—seconds or 1-2 minutes. The postictal phase may last for a longer period (several minutes). By definition, amnesia occurs during a complex partial seizure because of bilateral hemispheric involvement.
onder: I have several auras according to these lists! 
