How epileptogenic are temporal encephaloceles?

Encephaloceles are spontaneous or acquired abnormal herniations of the brain into congenital or acquired osseous-dural defects of the skull base or cranial vault. 1 When located in the middle fossa, they may present with medically intractable epilepsy, recurrent meningitis, CSF fistulas, middle ear fluid, or unilateral hearing loss. 1-3 Bony deficits may involve either the body or the greater wing of the sphenoid bone. Anteroinferior temporal encephaloceles, resulting from deficits of the horizontal portion of the greater sphenoidal wing laterally to the cranial base foramina of the sphenoidal bone, may be asymptomatic or lead to drug-resistant temporal lobe epilepsy. 1 It has long been recognized that the epilepsy associated with such encephaloceles can be surgically treated. 4,5