Anninos P, Kotini A, Tamiolakis D, Tsagas N
Lab of Medical Physics, Medical School, Democritus University of Thrace, University Campus, Alexandroupolis, Greece.
Acta Neurol Belg. 2006 Mar;106(1):26-30.
Transcranial magnetic stimulation (TMS) is a non-invasive tool for the electrical stimulation of neural tissue. TMS can be applied as single pulses of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies.
A 2-years-old male infant was referred to our department with a history of Epstein-Barr virus (EBV) encephalitis, treated with foscarnet and steroids, for he developed mutism and ataxia and loss of the ability to eat, walk and talk. Brain imaging revealed loss of white matter around ventricles and progressive global brain atrophy, findings consistent with encephalopathy. Serology for antibodies against EBV infection was positive and the diagnosis of acute and prolonged EBV infection was made. There was an improvement of the clinical findings after the application of TMS with proper field characteristics (intensity: 1-7.5 pT, frequency: 8-13 Hz).
Our case illustrates the possibility of therapeutic applications of TMS (in the order of pT) with proper field characteristics to normalize pathologically decreased levels of brain cortex activity. TMS might provide novel insights into the pathophysiology of the neural circuitry, be developed into clinically useful diagnostic and prognostic tests, and have therapeutic uses in various diseases.
经颅磁刺激（TMS）是一种用于电刺激神经组织的非侵入性工具。TMS 可作为单次刺激脉冲、以可变间隔施加于相同或不同脑区的成对刺激，或作为不同频率的重复刺激序列。
一名 2 岁男婴因患爱泼斯坦 - 巴尔病毒（EBV）脑炎前来我院就诊，此前接受过膦甲酸钠和类固醇治疗，现出现缄默症、共济失调以及丧失进食、行走和说话能力。脑部影像学检查显示脑室周围白质减少及进行性全脑萎缩，这些表现与脑病相符。针对 EBV 感染的抗体血清学检测呈阳性，确诊为急性及迁延性 EBV 感染。在应用具有适当场特性（强度：1 - 7.5 皮特斯拉，频率：8 - 13 赫兹）的 TMS 后，临床症状有所改善。
我们的病例表明，具有适当场特性（皮特斯拉量级）的 TMS 用于治疗，有可能使脑皮质活动水平的病理性降低恢复正常。TMS 可能为神经回路的病理生理学提供新的见解，有望发展成为临床上有用的诊断和预后检测手段，并在多种疾病的治疗中发挥作用。
