Epilepsy and TMS

Abstract

NBS has been used for epilepsy in three aspects: pathophysiology, antiepileptic drugs, and treatment. Pathophysiological analysis by TMS Several parameters of transcranial magnetic stimulation (TMS) studies are considered to reflect a specific electrophysiological function at the motor cortex. The motor threshold may represent sodium channel function; the short interval intracortical inhibition (SICI), GABAA function; intracortical facilitation (ICF), glutamate function. These functional abnormalities have been shown in several epileptic disorders. I will show GABAA dysfunction in patients with myoclonus epilepsy. Antiepileptic drugs and TMS The above methods TMS were used for studying the mechanism of action of most anti-epileptic drugs. The above functions were compared between real drug intake and placebo intake in normal subjects. Some drugs are compatible with sodium channel blocker, some others are enhancer of BAGAergic function, and some of them show glutamate blocker (AMPA blocker). These physiological speculations from human experiments are all compatible with their proposed mechanism action speculated from animal experiments. I will show the results of perampanel. Treatment by NBS Several NBS methods have been applied to patients with epilepsy. Repetitive TMS and transcranial magnetic stimulation (tDCS) were used for this purpose. I will describe quadripulse stimulation (QPS) and show an aggravation of epilepsy by LTD induction by QPS. We have no consensus about the effectiveness of rTMSs for epilepsy. Critical review of tDCS treatment of epilepsy concluded that no recommendation can be made about the potential efficacy of tDCS in the treatment of any type of epilepsy.