Transcranial Magnetic Stimulation and Refractory Partial Epilepsy

This chapter reviews the principles of transcranial magnetic stimulation (TMS) concerning its potential clinical use in diagnosis and therapy in medically intractable epilepsies. After introducing basic principles, stimulation protocols, and risks, TMS applications in epilepsies are summarized. Next, we discuss several clinical trials and animal studies, which show how low-frequency repetitive TMS (rTMS) may reduce seizure frequency and epileptiform discharges, mainly in focal epilepsy patients with neocortical epileptogenic zones such as malformations of cortical development. Lastly, we address some TMS effects on neurofunctional imaging. We conclude that rTMS should be considered one of the future noninvasive, relatively safe, and inexpensive therapeutic methods in patients with medically intractable epilepsies.