Transcranial magnetic stimulation in complex therapy of epilepsy

Abstract

Analysis of clinical, electroencephalographic and neuroimaging data of 19 patients with epilepsy after a course of repetitive transcranial magnetic stimulation (rTMS) in combination with subtherapeutic doses of anticonvulsants was performed. It was found that 1 Hz low-frequency temporal rTMS combined with anticonvulsants helps to reduce the number of weekly seizures by 91.9% during the course of this procedure, and by 75% during the month after completion of the combined course. rTMS courses lead to reduction of interictal epileptiform activity and decrease in the number of patients with pathological epileptic EEG phenomena, which may be seen not only in the stimulation period, but also during the following 4–12 weeks. rTMS has the long lasting effects on EEG parameters: increase in the alpharhythm power with frequency-spatial structure improvement, and decrease in the theta-rhythm and pathological beta-rhythm with minimization of the number and size of their focuses. The use of low-frequency and low-intensity rTMS together with subtherapeutic doses of anticonvulsants allows avoiding the development of side effects and ensuring high anti-seizure activity