Repetitive transcranial magnetic stimulation for post-stroke epilepsy: a mini-review

Abstract

Post-stroke epilepsy (PSE) is a common complication of stroke, significantly impacting patient's quality of life. Repetitive transcranial magnetic stimulation (rTMS) is an emerging potential non-invasive treatment for PSE. This review explores current evidence for rTMS in PSE, highlighting its potential benefits and limitations. Initial studies suggested that rTMS may reduce the seizure burden. Some studies observed a trend towards fewer seizures within two weeks of treatment initiation, indicating a relatively rapid response. Additionally, rTMS may be more effective when used in combination with medication, particularly for patients with specific lesion locations (frontal/temporal lobes) and seizure types (complex partial seizures). This points towards the potential of personalized treatment protocols. However, current evidence has limitations. Studies often involve small sample sizes and methodological variations, necessitating larger, well-designed trials with standardized protocols to confirm the efficacy and safety of rTMS in PSE. Future research should also focus on the optimization of treatment parameters, including stimulation frequency, duration, coil placement, and treatment course. Long-term studies are needed to evaluate the persistence of treatment effects on seizure control, cognitive function, and overall patient outcomes. Refining patient selection criteria and investigating the underlying mechanisms of therapeutic effects of rTMS in PSE are also crucial areas for future exploration.