Repetitive transcranial magnetic stimulation in treatment of epilepsia partialis continua [Author manuscript]
RATIONALE—Repetitive transcranial magnetic stimulation (rTMS) is a technique for noninvasive focal brain stimulation where small intracranial electrical currents are generated by a fluctuating extracranial magnetic field. In clinical epilepsy rTMS has been applied most often interictally to reduce s...
| Autores: | , , , , , |
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| Formato: | artículo |
| Fecha de publicación: | 2009 |
| País: | España |
| Recursos: | Universidad Católica de Valencia San Vicente Mártir |
| Repositorio: | RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir |
| Idioma: | inglés |
| OAI Identifier: | oai:riucv.ucv.es:20.500.12466/3515 |
| Acesso em linha: | http://hdl.handle.net/20.500.12466/3515 |
| Access Level: | acceso abierto |
| Palavra-chave: | Transcranial magnetic stimulation Seizure Epilepsia partialis continua 3205.07 Neurología |
| Resumo: | RATIONALE—Repetitive transcranial magnetic stimulation (rTMS) is a technique for noninvasive focal brain stimulation where small intracranial electrical currents are generated by a fluctuating extracranial magnetic field. In clinical epilepsy rTMS has been applied most often interictally to reduce seizure frequency. Less often, rTMS has been used to terminate ongoing seizures, as in instances of epilepsia partialis continua (EPC). Whether ictal rTMS is effective and safe in treatment of EPC has not been extensively studied. Here, we report our recent experience with rTMS in treatment of EPC, as an early step towards evaluating the safety and efficacy of rTMS in the treatment of intractable ongoing focal seizures. METHODS—Seven patients with EPC due to mixed etiologies were treated with rTMS applied over the seizure. rTMS was delivered in high frequency (20 to 100 Hz) bursts or as prolonged low frequency (1 Hz) trains. EEG was recorded in three of seven. RESULTS—rTMS resulted in a brief (20 – 30 minutes) pause in seizures in three of seven patients and a lasting (≥ 1 day) pause in two of seven. A literature search identified six additional reports of EPC treated rTMS where seizures were suppressed in three of six. Seizures were not exacerbated by rTMS in any patient. Generally mild side-effects included transient head and limb pain, and limb stiffening during high-frequency rTMS trains. CONCLUSIONS—Our clinical observations in a small number of patients suggest that rTMS may be safe and effective in suppressing ongoing seizures associated with EPC. However, a controlled trial is needed to assess the safety and anticonvulsive efficacy of rTMS in EPC treatment. |
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