Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature

Bae, Erica Hyunji; Schrader, Lara M.; Machii, Kenji; Alonso‐Alonso, Miguel; Riviello, James J.; Pascual‐Leone, Álvaro; Rotenberg, Alexander

doi:10.1016/j.yebeh.2007.03.004

Cited by 183 publications

(97 citation statements)

References 46 publications

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“…Because rTMS primarily affects cortical areas up to 1.5-2 cm beneath the skull, patients with epileptogenic foci in subcortical (deep) regions are unlikely to significantly benefit from rTMS. A literature review investigating the adverse effects of rT-MS in patients with epilepsy found that adverse events occurred in 17.1% of patients, with the most common being transient headaches (9.6%) and general feelings of discomfort and weakness (Bae et al, 2007). While there have been some reported cases of seizures induced by rTMS, this was found to be a rare event with a crude risk of 1.4%.…”

Section: Development and Usesmentioning

confidence: 99%

Neurostimulation, neuromodulation, and the treatment of epilepsies

Bolden¹,

Pati²,

Szaflarski³

2015

Journal of Epileptology

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SUMMARYIntroduction. Neurostimulation and neuromodulation are techniques that may be able to affect the course of epilepsy. In the last 20 years, since the approval of VNS, we have observed a surge of studies assessing the potential of other devices and techniques for the treatment of pharmacoresistant epilepsies including deep brain stimulation (DBS), responsive neurostimulation (RNS), trigeminal nerve stimulation (TNS), transcranial direct current stimulation (tDCS), and repetitive transcranial magnetic stimulation (rTMS). Are these devices and techniques simply another treatment option that can be offered to patients with epilepsy or do they offer specific advantages when compared to the standard antiepileptic drugs (AEDs)? Aim. The aim of this review is to present the neurostimulation and neuromodulation devices and techniques that are now in use, or at least available for testing and to discuss the science behind them, their applications, efficacy, potential risks vs. benefits and, above all, how to navigate the choices so clinicians are able to provide their patients with the best possible option for the treatment of epilepsy. Material and methods. We analyzed PubMed and MEDLINE databases to select the most salient and recent (up to November 2014) publications on each treatment device. In addition to these searches bibliographies of selected articles were hand-searched for possible sources. Discussion and conclusions. Great progress in neurostimulation and neuromodulation has been made over the last two decades with 2 devices (VNS, RNS) approved for the treatment of epilepsy in the US and three (DBS in addition to VNS and RNS) in Europe. The future of neuromodulation/neurostimulation is exciting -various studies and efforts are underway and will provide us with more data in the future. There appears to be one clear advantage of these treatments/devices over the AEDs that is consistently noted -routinely observed is continuous improvement in seizure control over time. This is something that the AEDs have thus far failed to deliver.

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Section: Development and Usesmentioning

confidence: 99%

Neurostimulation, neuromodulation, and the treatment of epilepsies

Bolden¹,

Pati²,

Szaflarski³

2015

Journal of Epileptology

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“…Studies of safety evaluation of the combinations of parameters (0.5 Hz, 50 pulses; 8 Hz, 1000 pulses; 20 Hz, 1500 pulses; 25 Hz, 1200 pulses) showed that rTMS delivered in any combination of parameters was safe (Liebetanz et al,2003;Frye et al,2008;Post et al,1999). Bae EH et al (Bae et al,2007) performed an English-language literature search, and reviewed all studies published from January 1990 to February 2007 in which patients with epilepsy were treated with rTMS. They found that the adverse events attributed to rTMS were generally mild and occurred in 17.1% of subjects; headache was most common, occurring in 9.6%; seizures occurred in 4 patients (1.4%); all but one case were the patients' typical seizures with respect to duration and semiology, and were associated with low-frequency rTMS; a single case had atypical seizure appearing to arise from the region of stimulation during high-frequency rTMS; no rTMS-related episodes of status epilepticus were reported.…”

Section: The Safety Issue Of Rtmsmentioning

confidence: 99%

The Clinical Application of Transcranial Magnetic Stimulation in the Study of Epilepsy

Wang¹,

Yu²

2011

Management of Epilepsy - Research, Results and Treatment

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“…Small intracranial electrical currents are generated by a strong fluctuating extracranial magnetic field [62][63][64]. rTMS has been applied with therapeutic attempts in several pathologies such as depression, pain, tinnitus and stroke, and also in epilepsy patients.…”

Section: Transcranial Magnetic Stimulationmentioning

confidence: 99%

Possible new avenues in epilepsy treatment: the stimulation techniques deep brain stimulation, vagal nerve stimulation, transcranial magnetic stimulation

Boëx

Brodbeck²,

Vulliémoz³

et al. 2011

Swiss Arch Neurol Psychiatr

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SummaryStimulation techniques have been extensively explored as new treatments for epilepsy, and their efficacy is still being investigated, albeit several approaches appear to be very promising. Vagal nerve stimulation (VNS) has been a well established palliative therapy for almost 20 years, however, complete seizure control is rarely obtained. Its favourable effect on mood has been noted in several studies, and VNS was FDA-approved for the treatment of major depression in 2005. Intracerebral electrical stimulation is currently being evaluated as apotential treatment for patients with drug-resistantfocal epilepsy in whom surgery cannot be offered. We summarise the results of various studies applying deep brain stimulation (DBS) to different brain structures, particularly to the mesial temporal lobe. From these studies, it appears that the efficiency of DBS to reduce epileptic seizures is demonstrated in a sufficiently large patient population but the exact determinants (physical parameters, syndromes) of its success (or its absence) remain unknown. Repetitive Transcranial Magnetic Stimulation (rTMS) has been investigated as an antiepileptic treatment in patients with focal seizure onset by several groups, however, the clinical success is variable and in most studies rather low.

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Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature

Cited by 183 publications

References 46 publications

Neurostimulation, neuromodulation, and the treatment of epilepsies

Neurostimulation, neuromodulation, and the treatment of epilepsies

The Clinical Application of Transcranial Magnetic Stimulation in the Study of Epilepsy

Possible new avenues in epilepsy treatment: the stimulation techniques deep brain stimulation, vagal nerve stimulation, transcranial magnetic stimulation

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