EFFICACY OF ADJUNCTIVE LOW FREQUENCY (0.3 HZ) RTMS OVER VERTEX IN LOCALIZATION RELATED EPILEPSY IN CHILDREN AND ADOLESCENT: A RANDOMIZED DOUBLEBLINDED SHAM CONTROLLED STUDY
Dr. Nirmalya Mukherjee*, Prof. Vinod Kumar Sinha, Dr. Nishant Goyal, Dr. Gargi Mondal, Dr. Umesh Srikanthie
ABSTRACT
Objectives: Low-frequency (<1Hz) rTMS decreases the excitability of the cortical areas. Mixed results noted in reducing seizure using <1Hz rTMS in adults. We evaluate the efficacy of adjunctive vertex 0.3 Hz rTMS in focal epilepsy in children and adolescent. Methods: 30 patients, of either sex, aged eight to eighteen years, with ≥4 paroxysms of localization related seizures in last month on continuous anti-epileptics were included and divided randomly in to active or sham group. Active group received two daily sessions (30 seconds apart) of 300 stimuli/train of rTMS (100% MT) at 0.3 Hz, over vertex for 5 days. Sham group received stimulation with same protocol except the coil being placed vertical to scalp. Seizure frequency were compared
pre- vs. up to 3 months post-stimulation. EEG was recorded baseline and after last rTMS session. Result: No significant difference noted between two groups in seizure frequency change over time. No significant change in interictal epileptiform discharges between pre and post stimulation found. Conclusion: Adjunctive 0.3 Hz rTMS over vertex has no significant effect in epilepsy treatment in children and adolescent but medication interaction effect can’t be ignored. In future, localised stimulation on the affected lobe can be tried with more homogeneous sample.
Keywords: rTMS (0.3Hz), vertex, paediatric population, localization related epilepsy.
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