Department of Clinical Neurophysiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
Epilepsy Behav. 2012 Nov;25(3):468-72. doi: 10.1016/j.yebeh.2012.07.026. Epub 2012 Sep 12.
This study aimed to investigate the effect of low frequency repetitive transcranial magnetic stimulation (rTMS) guided as to localization and effect by continuous EEG on a super-refractory status epilepticus unresponsive to conventional treatment for 44 days including repeated deep sedation. Repetitive transcranial magnetic stimulation was delivered for one-hour sessions to the most active of two EEG foci for 8 days. From the third day of stimulation, the EEG pathology markedly decreased in parallel to clinical improvement. The patient could be weaned off the respirator, transferred to an ordinary ward then to a rehabilitation clinic. This is the first report of a positive outcome of rTMS treatment in super-refractory status epilepticus. In the context of refractory partial status epilepticus, neuromodulation through rTMS is a safe treatment option. If performed along the lines herein described, it may also be more efficient than conventional treatment. Repetitive transcranial magnetic stimulation may be an underused treatment option for status epilepticus.
本研究旨在探讨低频重复经颅磁刺激（rTMS）引导下的连续脑电图定位和效果对常规治疗 44 天无效的超难治性癫痫持续状态的影响，其中包括反复深度镇静。rTMS 治疗持续 8 天，每天进行 1 小时的治疗，针对两个脑电图焦点中最活跃的一个进行治疗。从刺激的第三天开始，脑电图病理明显减少，同时临床状况也得到改善。患者可以脱离呼吸机，转至普通病房，然后再到康复诊所。这是 rTMS 治疗超难治性癫痫持续状态的首个积极结果报告。在难治性部分性癫痫持续状态的情况下，rTMS 神经调节是一种安全的治疗选择。如果按照本文所述的方式进行操作，它可能比传统治疗更有效。rTMS 可能是癫痫持续状态中未充分利用的治疗选择。
