Temporal Lobe Epilepsy and Right Amygdala Enlargement

A 49-year-old man with a long-standing history of seizures and prominent psychiatric symptoms—including uncontrollable laughing, crying, and visual hallucinations—presented with recurrent events beginning in 2019. His seizures, initially attributed to alcohol withdrawal, persisted despite cessation of alcohol and occurred 1–2 times per month. Typical events consisted of loss of eye contact, staring spells, visual aura, impaired awareness, and occasional secondary generalization. EEG recordings were normal; however, MRI performed in 2024 revealed enlargement of the right amygdala. The findings are consistent with Temporal Lobe Epilepsy (TLE) related to right amygdala enlargement, a relatively uncommon subtype that may occur without hippocampal sclerosis and is frequently associated with emotional or behavioural disturbances.