Transcranial magnetic stimulation for drug-resistant epilepsies: rationale and clinical experience

Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique which, over the last 25 years, has greatly expanded from a simple method for stimulating the motor cortex to an invaluable tool with multiple research, diagnostic and even therapeutic applications. In this review, we discuss the use of repetitive TMS as a means of suppressing cortical hyperexcitability in drug-resistant epilepsies. The theoretical background and the experimental evidence in favor of this novel therapeutic approach are presented, and a number of open-label and controlled studies in patients with various forms of focal epilepsy are reviewed. It is concluded that, although the therapeutic effects of repetitive TMS in epilepsy appear rather limited, further clinical testing of this rapidly evolving technology is warranted.