Seizure induced by sub-threshold 10-Hz rTMS in a patient with multiple risk factors

Gómez, Lázaro; Morales, Lilia; Trápaga, O.; Zaldivar, M.; Sánchez, Abel; Padilla, Elizabeth; Grass, Daymee; Díaz, Amado; Morales, H. García

doi:10.1016/j.clinph.2010.09.007

Cited by 12 publications

(7 citation statements)

References 4 publications

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“…Briefly, 19 cases had HF-rTMS (>3 Hz), 23 – 34 , 42 four cases with multiple single-pulse stimulations, 23 , 35 – 38 , 42 one continuous theta-burst stimulation (cTBS), 39 and one not reported. 40 Fifteen reports were cases where motor cortex was stimulated, 23 , 28 , 29 , 32 , 35 – 39 , 41 , 42 nine where prefrontal cortex was stimulated, 24 – 27 , 30 , 31 , 33 , 34 and one not reported. 40 The intensity of stimulation used is very heterogeneous and ranges from 40% to 130% resting motor threshold (RMT).…”

Section: Resultsmentioning

confidence: 99%

Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

Dobek¹,

Blumberger²,

Downar³

et al. 2015

NDT

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ObjectiveWhen considering repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder, clinicians often face a lack of detailed information on potential interactions between rTMS and pharmacotherapy. This is particularly relevant to patients receiving bupropion, a commonly prescribed antidepressant with lower risk of sexual side effects or weight increase, which has been associated with increased risk of seizure in particular populations. Our aim was to systematically review the information on seizures occurred with rTMS to identify the potential risk factors with attention to concurrent medications, particularly bupropion.Data sourcesWe conducted a systematic review through the databases PubMed, PsycINFO, and EMBASE between 1980 and June 2015. Additional articles were found using reference lists of relevant articles. Reporting of data follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Study selectionTwo reviewers independently screened articles reporting the occurrence of seizures during rTMS. Articles reporting seizures in epilepsy during rTMS were excluded. A total of 25 rTMS-induced seizures were included in the final review.Data extractionData were systematically extracted, and the authors of the applicable studies were contacted when appropriate to provide more detail about the seizure incidents.ResultsTwenty-five seizures were identified. Potential risk factors emerged such as sleep deprivation, polypharmacy, and neurological insult. High-frequency-rTMS was involved in a percentage of the seizures. None of these seizures reported had patients taking bupropion in the literature review. One rTMS-induced seizure was reported from the Food and Drug Administration in a sleep-deprived patient who was concurrently taking bupropion, sertraline, and amphetamine.ConclusionDuring the consent process, potential risk factors for an rTMS-induced seizure should be carefully screened for and discussed. Data do not support considering concurrent bupropion treatment as contraindication to undergo rTMS.

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Section: Resultsmentioning

confidence: 99%

Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

Dobek¹,

Blumberger²,

Downar³

et al. 2015

NDT

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“…Seizures are certainly dangerous and undesirable. However, all of the 17 or so reported seizures with rTMS (Gomez, et al, 2011; Rossi, et al, 2009) have occurred under observation and resolved rapidly and spontaneously without serious sequelae. Therefore, we question whether the optimal risk-benefit balance for a severely depressed population undergoing rTMS treatment requires a seizure rate of virtually zero and substantially less than that of conventional antidepressant medications (Mula, et al, 2008).…”

Section: Therapeutic Applicationsmentioning

confidence: 99%

Transcranial magnetic brain stimulation: Therapeutic promises and scientific gaps

Wassermann

Zimmermann

2012

Pharmacology & Therapeutics

200

130

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Since its commercial advent in 1985, transcranial magnetic stimulation (TMS), a technique for stimulating neurons in the cerebral cortex through the scalp, safely and with minimal discomfort, has captured the imaginations of scientists, clinicians and lay observers. Initially a laboratory tool for neurophysiologists studying the human motor system, TMS now has a growing list of applications in clinical and basic neuroscience. Although we understand many of its effects at the system level, detailed knowledge of its actions, particularly as a modulator of neural activity, has lagged, due mainly to the lack of suitable non-human models. Nevertheless, these gaps have not blocked the therapeutic application of TMS in brain disorders. Moderate success has been achieved in treating disorders such as depression, where the U.S. Food and Drug Administration has cleared a TMS system for therapeutic use. In addition, there are small, but promising, bodies of data on the treatment of schizophrenic auditory hallucinations, tinnitus, anxiety disorders, neurodegenerative diseases, hemiparesis, and pain syndromes. Some other nascent areas of study also exist. While the fate of TMS as a therapeutic modality depends on continued innovation and experimentation, economic and other factors may be decisive.

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“…This patient had at least three possible risk factors for seizures, as reviewed by Rossi et al [2]: prior head trauma [3], alcohol use the night before the seizure [1,4–6] and poor sleep [7,8]. To our knowledge, this is the third reported case of an induced seizure using an H-coil, with one occurring in a patient undergoing treatment for depression and the other in a patient being treated for bipolar disorder [1,9].…”

Section: Discussionmentioning

confidence: 99%

H-Coil Repetitive Transcranial Magnetic Stimulation Induced Seizure in an Adult with Major Depression: A Case Report

et al. 2016

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Seizure induced by sub-threshold 10-Hz rTMS in a patient with multiple risk factors

Cited by 12 publications

References 4 publications

Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

Transcranial magnetic brain stimulation: Therapeutic promises and scientific gaps

H-Coil Repetitive Transcranial Magnetic Stimulation Induced Seizure in an Adult with Major Depression: A Case Report

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