Repetitive transcranial magnetic stimulation for the treatment of refractory epilepsy

ABSTRACT

Introduction: Repetitive transcranial magnetic stimulation (rTMS) is an established non-invasive neurostimulation technique that is able to induce neuromodulatory effects outlasting the duration of the stimulation train. The cortical excitability disturbance in epilepsy provides a rationale for investigating the efficacy of low-frequency rTMS as a treatment for epilepsy patients. Sofar clinical trials in epilepsy patients have shown conflicting results ranging from ineffective to very effective.

Areas covered: This manuscript provides an overview of the performed studies, retrieved from a PubMed search, and a critical appraisal of their results. A number of conclusions are drawn and potential optimization strategies are discussed.

Expert commentary: Although the therapeutic efficacy of rTMS in refractory epilepsy has not yet been established, the non-invasiveness of the technique warrants further investigation of rTMS as a treatment for epilepsy.

KEYWORDS:

• Repetitive transcranial magnetic stimulation (rTMS)
• treatment
• clinical outcome
• epilepsy
• status epilepticus (SE)
• epilepsia partialis continua (EPC)

Acknowledgements

The authors would like to acknowledge Alcinoo Giandinoto for designing the illustrations.

Declaration of interest

Sofie Carrette is supported by an aspirant grant from ‘Fonds voor Wetenschappelijk Onderzoek’ (FWO) Flanders. She has received a travel grant from Magventure to participate in a TMS course. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.