Repetitive transcranial magnetic stimulation directed to a seizure focus localized by high-density EEG: A case report

Abstract

We demonstrate feasibility of using high-density EEG to map a neocortical seizure focus in conjunction with delivery of magnetic therapy. Our patient had refractory seizures affecting the left leg. A five-day course of placebo stimulation followed a month later by active rTMS was directed to the mapped seizure dipole. Active rTMS resulted in reduced EEG spiking, and shortening of seizure duration compared to placebo. Seizure frequency, however, improved similarly in both placebo and active treatment stages. rTMS-evoked EEG potentials demonstrated that a negative peak at 40 ms - believed to represent GABAergic inhibition - was enhanced by stimulation.

EEG Evoked Potentials to Repetitive Transcranial Magnetic Stimulation in Normal Volunteers: Inhibitory TMS EEG Evoked Potentials

“…This potentially affords an opportunity to use TEPs as a biomarker of rTMS or TBS efficacy. Changes in TEPs in response to rTMS treatment were demonstrated by the present authors in a single case study of a patient with epilepsy, also correlating with improvement in seizures [42].…”

No effect of electrical transcranial direct current stimulation adjunct treatment for epilepsia partialis continua in POLG disease

“…According to guidelines published by a European expert consortium in 2017, and several reviews, it is not yet possible to draw conclusions regarding the efficacy of tDCS in any kind of epilepsy, even though there are some promising results [[12], [13], [14], [15]]. Similarly, it remains unclear whether transcranial magnetic stimulation (TMS), another type of non-invasive brain stimulation, is an effective treatment of epilepsy [[16], [17], [18]], although there are some positive findings for epilepsia partialis continua [19]. Even less is known about how these non-invasive brain stimulation techniques will affect patients with mitochondrial diseases.…”