Q 1.19. Temporal Lobe Syndromes

Anatomy and Function:

  • The temporal lobes are one of the four major lobes of the cerebral cortex.
  • They perform a complex array of interrelated functions and play an essential role in various day-to-day activities.


Key structures and their roles:


  • Primary Auditory Cortex (Heschl gyrus): Responsible for processing auditory information, it allows us to interpret sounds and language.
  • Wernicke’s Area: Located in the left temporal lobe, it’s crucial for language comprehension.
  • Hippocampus: Deep within the temporal lobe, it plays a significant role in the formation of long-term memories and spatial navigation.
  • Parahippocampal gyrus: grey matter cortical region of the brain that surrounds the hippocampus and is part of the limbic system. This region plays an important role in memory encoding and retrieval. It includes areas such as the perirhinal and entorhinal cortices and is involved in various functions, including scene recognition and social context, such as understanding paralinguistic elements of communication.
  • Amygdala: Involved in emotion processing, especially fear and pleasure, and contributes to memory formation.
  • Fusiform Gyrus: Important for facial recognition and processing complex visual information.


Common Pathologies:

Temporal lobe dysfunction can result from various conditions, including:

  • Infarction (usually due to middle cerebral artery involvement)
  • Hemorrhage
  • Seizures
  • Tumors
  • Encephalitis
  • Traumatic brain injury


Hearing Loss: The temporal lobe, particularly the primary auditory cortex, is crucial for interpreting sounds. Damage to this area may not necessarily affect pure-tone thresholds (the ability to detect sounds at different pitches), but it can impair more complex auditory functions such as speech recognition and sound localization. Patients with temporal lobe epilepsy, for example, often exhibit central auditory processing deficits.


Visual Loss: While the temporal lobe is not the primary visual processing center, it does contribute to the integration of visual information, particularly complex stimuli like faces and scenes. Lesions in the temporal lobe can cause difficulties with visual perception and may lead to a condition known as a visual field defect, where the patient is unable to see one area in their field of vision like the homonymous quadrantopsia.


Temporal Lobe Syndromes:

These syndromes manifest in different ways based on the specific area affected within the temporal lobe.


Some notable syndromes include:

  • Kluver-Bucy syndrome: Characterized by hyperorality, hypersexuality, and visual agnosia.
  • Geschwind-Gastaut syndrome: Associated with hypergraphia, hyperreligiosity, and mood changes.
  • Gerstmann syndrome is a neurological disorder characterized by a specific set of cognitive impairments that typically arise from damage to the dominant (usually left) hemisphere of the brain, particularly the angular gyrus located at the junction of the temporal and parietal lobes. The syndrome is marked by four primary symptoms:

    • Dysgraphia/Agraphia: Difficulty with writing.
    • Dyscalculia/Acalculia: Difficulty with mathematics and calculation.
    • Finger Agnosia: Inability to distinguish and recognize the fingers.
    • Left-Right Disorientation: Difficulty in telling left from right.
  • Hallucinations: Abnormal sensory and auditory perceptions.
  • Anxietyagitation, and aggression (neuropsychiatric symptoms).
  • Aphasia (language impairment) when the left temporal lobe is involved.


Clinical Presentation:

    • The presentation depends on factors like whether the dominant or non-dominant lobe is involved.
    • Left temporal lobe damage often leads to various forms of aphasia.
    • Right temporal lobe involvement results in diverse and less obvious syndromes.







Verified by Dr. Petya Stefanova