Transcranial magnetic stimulation for refractory focal status epilepticus in the intensive care unit

Seizure. 2013 Dec;22(10):893-6. doi: 10.1016/j.seizure.2013.06.014. Epub 2013 Jul 19.

Abstract

Purpose: To examine the efficacy and safety profile of antiepileptic repetitive transcranial magnetic stimulation (rTMS) for refractory status epilepticus (RSE) in the intensive care unit (ICU) setting. In addition, hypothetical concerns about electrical interference of rTMS with ICU equipment have been previously raised.

Methods: We describe two cases of RSE treated with rTMS in the ICU.

Results: In one case, rTMS contributed to decreased seizure frequency; in the second case, rTMS transiently decreased seizure frequency. In both cases, rTMS was safe and did not interfere with the functioning of the ICU equipment.

Conclusion: rTMS is a potential therapy for RSE when conventional therapies have failed. Future studies should investigate the efficacy of various rTMS stimulation parameters, safety issues, and bioengineering considerations in the ICU setting.

Keywords: Epilepsia partialis continua; Intensive care unit; Refractory status epilepticus; Transcranial magnetic stimulation.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticonvulsants / therapeutic use
  • Electroencephalography
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Status Epilepticus / drug therapy
  • Status Epilepticus / therapy*
  • Transcranial Magnetic Stimulation / adverse effects*
  • Treatment Outcome

Substances

  • Anticonvulsants