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Updated: Oct 2, 2025
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Repetitive transcranial magnetic stimulation (rTMS) as therapy in an infant with epilepsia partialis continua
Diana Chang1, Nilika S Singhal2, Phiroz E Tarapore3
1University of California, San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143, United States.
Insights
Repetitive transcranial magnetic stimulation (rTMS) safely stopped seizures in a 10-month-old infant with drug-resistant epilepsy. This treatment offers a new option for managing severe pediatric epilepsy cases.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Neuroscience
Background:
- Drug-resistant epilepsy in infants presents significant treatment challenges.
- Pathogenic POLG1 mutations are associated with severe epilepsy syndromes.
- Epilepsia partialis continua (EPC) is a rare, severe form of epilepsy.
Observation:
- A 10-month-old infant with POLG1 mutations experienced chronic, drug-resistant EPC.
- Seizures manifested as continuous left-sided jerking of limbs.
- Standard epilepsy treatments, including surgery, were ineffective.
Findings:
- Repetitive transcranial magnetic stimulation (rTMS) was administered using an activating protocol.
- rTMS successfully interrupted the persistent seizures, inducing a temporary lesion effect.
- The infant tolerated the rTMS therapy without adverse events.
Implications:
- rTMS is a potentially safe and effective treatment for infantile epilepsy.
- This case demonstrates the feasibility of rTMS in very young children (10 months old).
- rTMS may offer a novel therapeutic strategy for intractable pediatric epilepsy.
Abstract:
Introduction: We present a case of a 10-month-old girl undergoing repetitive TMS (rTMS) for the treatment of drug-resistant epilepsy. Case report: A 10-month-old girl, later diagnosed with pathogenic POLG1 mutations, presented to our institution with chronic progressive EPC (epilepsia partialis continua) manifesting as a frequent, left-sided, synchronous continuous jerking of the arms and legs. The seizures were drug-resistant to multiple antiseizure medications and epilepsy surgery, responding only to continuous anesthesia. rTMS therapy was attempted to interrupt seizures. Results: rTMS therapy, using an activating protocol to introduce a temporary lesion effect, was used to interrupt persistent, ongoing seizures. Conclusion: rTMS can be safely used to abort seizures in patients as young as 10 months old.
