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TMS for the Diagnosis and Treatment of Epilepsy

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TMS for the Diagnosis and Treatment of Epilepsy

Localization of the Epileptogenic Zone


The interest in this application of TMS has been rather limited up to now primarily because of the inability to record reliably EEG signals concurrently with brain stimulation. However, the recent advent of TMS–EEG is expected to increase significantly the clinical and research interest in this field.

Valentin et al. investigated 15 patients with focal epilepsies and a group of normal controls by delivering TMS stimuli at standard positions of the 10–20 system. The authors recorded early EEG responses, which corresponded to the normal N100 waveform, and late responses, which resembled the typical interictal discharges or took the form of repetitive rhythmic activity. Interestingly, the late TMS–EEG responses were never observed in the control group but were present in 11 out of 15 epileptic patients. On the basis of these data, the authors concluded that TMS–EEG can reliably identify the epileptogenic zone and may significantly improve the diagnostic approach to epilepsy.

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