Seizure in a patient receiving transcranial magnetic stimulation treatment

Abstract

Transcranial magnetic stimulation (TMS), a non-invasive technique that enables the stimulation of the brain tissue, has been used not only in neurophysiological research aimed at localizing cortical functions but also in the treatment of nervous disorders. It includes administration of single or repetitive magnetic pulses of adjustable intensity and frequency to a certain part of the nervous system. Depression is the leading illness on which the most robust data have been increasingly collected since the introduction of TMS into clinical use in 1985. Many clinical studies have demonstrated that TMS is effective in the treatment of depression. TMS has also been used in depressive patients resistant to pharmacological intervention and found to have higher efficacy compared with sham TMS. Although various parts of the both hemispheres have been stimulated by employing different parameters, 90 percent of depressive patients included in clinical studies have received repetitive stimulations of high frequency to dorsolateral prefrontal cortex. It has been reported that the most serious side effect of repetitive and high-frequency TMS is the occurrence of seizures. We present a case that had a generalized tonic-clonic seizure during TMS treatment and literature on TMS-induced seizure is reviewed.