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rTMS reduces focal brain hyperperfusion in two patients with EPC

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Graff-Guerrero A, Gonzáles-Olvera J, Ruiz-García M, Avila-Ordoñez U, Vaugier V, García-Reyna JC. rTMS reduces focal brain hyperperfusion in two patients with EPC.

Acta Neurol Scand 2004: 290–296. © Blackwell Munksgaard 2003. Objective –

This study was performed to evaluate the acute effect of a single repetitive transcranial magnetic stimulation (rTMS) session in a focal hyperperfusion epileptogenic region to induce a transitory decrease of epileptiform activity. Case report –

Two epilepsia partialis continua (EPC)-diagnosed patients, received one session with 15 trains of rTMS (20 Hz; 2 s train, inter-train of 58 s). Before rTMS session, a brain ictal single photon emission computed tomography (SPECT) was performed to localize the focal frontal hyperperfusion region to establish the stimulation site. Immediately after the rTMS session another ictal SPECT was performed. Both patients showed a decrease of perfusion in the stimulated regions. For patient 1 epileptic seizures became intermittent until they stopped in the following 24 h. Patient 2 showed only a minimal improvement with a frequency decrease of epileptic spikes. Conclusions –

Our findings suggest that a single rTMS session reduces focal epileptogenic activity and could be an alternative approach for epileptic-resistant patients, but efficacy should be confirmed in a larger series.

Keywords: cerebral blood flow; epilepsia; epilesia partialis continua; rTMS; single photon emission computed tomography; transcranial magnetic stimulation

Document Type: Research Article


Affiliations: 1: Instituto Nacional de Psiquiatría Ramón de la Fuente, División de Servicios Clínicos, México DF 2: Instituto Nacional de Pediatría, Servicio de Neurología, México DF

Publication date: 2004-04-01

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