Low-frequency transcranial magnetic stimulation for epilepsia partialis continua due to cortical dysplasia


      The potential therapeutic role of repetitive transcranial magnetic stimulation (rTMS) in epilepsy has been increasingly recognized. We investigated the effects of low-frequency rTMS in a patient with epilepsia partialis continua (EPC) due to cortical dysplasia. A 31-year-old female patient experienced EPC in the right upper and lower extremities, which had lasted for 15 years without generalized seizures. MRI showed focal megaencephaly around the motor cortex suggestive of cortical dysplasia. A figure of eight magnetic coil was placed over the hand motor area, and 100 stimuli with an intensity at 90% of motor threshold were given at 0.5 Hz. Immediately after rTMS, EPC was nearly abolished. The effects had continued approximately for 2 months, and the second trial resulted in the similar effects and time-course. Low-frequency rTMS was safe and well tolerated in this patient. These findings support the concept that rTMS decreases cortical excitability, and may be an effective treatment for focal partial seizures.


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        • Tergau F.
        • Naumann U.
        • Paulus W.
        • Steinhoff B.J.
        Low-frequency repetitive transcranial magnetic stimulation improves intractable epilepsy.
        Lancet. 1999; 353: 2209
        • Menkes D.L.
        • Gruenthal M.
        Slow-frequency repetitive transcranial magnetic stimulation in patient with focal cortical dysplasia.
        Epilepsia. 2000; 41: 240-242
        • Theodore W.H.
        • Hunter K.
        • Chen R.
        • Vega-Bermudez F.
        • Boroojerdi B.
        • Reeves-Tyer P.
        • et al.
        Transcranial magnetic stimulation for the treatment of seizures. A controlled study.
        Neurology. 2002; 59: 560-562
        • Daniele O.
        • Brighina F.
        • Piazza A.
        • Giglia G.
        • Scalia S.
        • Fierro B.
        Low-frequency transcranial magnetic stimulation in patients with cortical dysplasia. A preliminary study.
        J Neurol. 2003; 250: 761-762
        • Chen R.
        • Classen J.
        • Gerloff C.
        • Celnik P.
        • Wassermann E.M.
        • Harllett M.
        • et al.
        Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation.
        Neurology. 1997; 48: 1398-1403
        • Wassermann E.M.
        Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the international workshop on the safety of repetitive transcranial magnetic stimulation.
        Electroencephalogr Clin Neurophysiol. 1998; 108: 1-16
        • Akamatsu N.
        • Fueta Y.
        • Endo Y.
        • Matsunaga K.
        • Uozumi T.
        • Tsuji S.
        Decreased susceptibility to phentylenetetrazol-induced seizures after low-frequency transcranial magnetic stimulation in rats.
        Neurosci Lett. 2001; 310: 153-156
        • Misawa S.
        • Kuwabara S.
        • Hirano S.
        • Shibuya K.
        • Arai K.
        • Hattori T.
        • et al.
        Epilepsia partialis continua as an isolated manifestation of motor cortical dysplasia.
        J Neurol Sci. 2004; 225: 157-160
        • Taylor D.C.
        • Falcorner M.A.
        • Bruton C.J.
        • Corsellis J.A.
        Focal dysplasia of the cerebral cortex in epilepsy.
        J Neurol Neurosurg Psychiatry. 1971; 34: 369-387
        • Matsuda K.
        • Mihara T.
        • Tottori T.
        • Otubo T.
        • Usui N.
        • Baba K.
        • et al.
        Neuroradiologic findings in focal cortical dysplasia: histologic correlation with surgically resected specimens.
        Epilepsia. 2001; 42: S29-S36
        • Fusco L.
        • Vigevano F.
        Reversible operculum syndrome caused by progressive epilepsia partialis continua in a child with left hemimegalencephaly.
        J Neurol Neurosurg Psychiatry. 1991; 54: 556-558
        • Desbiens R.
        • Berkovic S.F.
        • Dubeau F.
        • Andermann F.
        • Laxer K.D.
        • Harvey S.
        • et al.
        Life-threatening focal status epileptics due to occult cortical dysplasia.
        Arch Neurol. 1993; 50: 695-700
        • Tassinari C.A.
        • Cincotta M.
        • Zaccara G.
        • Michelucci R.
        Transcranial magnetic stimulation and epilepsy.
        Clin Neurophysiol. 2003; 114 ([Review]): 777-798