Algoet Chloé, Carrette Sofie, Meurs Alfred, Mertens Ann, Hemelsoet Dimitri, Boon Paul, Vonck Kristl
Department of Neurology, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
Bioelectron Med. 2025 May 23;11(1):12. doi: 10.1186/s42234-025-00175-8.
BACKGROUND: Epilepsia partialis continua (EPC) is a medication-resistant form of focal status epilepticus (SE), causing significant morbidity. This case series explored whether continuous theta burst stimulation (cTBS) could reduce seizure activity in patients with EPC. METHODS: Three patients with motor EPC (2M/1F) underwent an accelerated cTBS protocol over four consecutive days (five 40-s trains/day, 5Hz bursts, 3 pulses at 50Hz/burst). Stimulation targeted the epileptogenic zone using a figure-of-eight coil at 80% of the resting motor threshold. Electroencephalography (EEG) was conducted before and after each session. Seizure frequency, intensity, adverse events (AEs), seizure diaries, and follow-up data were assessed. RESULTS: cTBS did not interrupt EPC in any patient. One patient reported a 17% reduction in seizure frequency. Another noted mild improvement in shoulder jerks, and a third reported reduced arm tension, though without clinical confirmation. EEG showed no significant changes. One patient experienced seizures during stimulation, and another reported worsening of pre-existing headaches. CONCLUSION: In this small case series, a four-day accelerated cTBS protocol did not yield clinically meaningful seizure control in EPC. Further research is needed to evaluate TMS and TBS in SE and EPC, where a significant treatment gap remains.
背景:部分性持续性癫痫(EPC)是一种药物难治性局灶性癫痫持续状态(SE),会导致严重的发病情况。本病例系列研究了连续theta爆发刺激(cTBS)是否能降低EPC患者的癫痫发作活动。 方法:三名运动性EPC患者(2名男性/1名女性)连续四天接受加速cTBS方案(每天5次40秒的序列,5赫兹爆发,每次爆发50赫兹有3个脉冲)。使用8字线圈以静息运动阈值的80%为目标刺激致痫区。每次治疗前后均进行脑电图(EEG)检查。评估癫痫发作频率、强度、不良事件(AE)、癫痫发作日记和随访数据。 结果:cTBS在任何患者中均未中断EPC。一名患者报告癫痫发作频率降低了17%。另一名患者指出肩部抽搐有轻度改善,第三名患者报告手臂张力降低,但未经临床证实。EEG显示无显著变化。一名患者在刺激期间出现癫痫发作,另一名患者报告原有头痛加重。 结论:在这个小病例系列中,为期四天的加速cTBS方案在EPC中未产生具有临床意义的癫痫发作控制效果。在SE和EPC中仍存在显著治疗差距,需要进一步研究以评估经颅磁刺激(TMS)和theta爆发刺激(TBS)。
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