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. Author manuscript; available in PMC: 2013 May 17.
Published in final edited form as: Brain Stimul. 2011 Jun 14;5(3):320–9.e27. doi: 10.1016/j.brs.2011.05.003

Table 8. Seizures induced by rTMS in patients with positive sensory symptoms.

Details of three case reports are summarized. ABP, abductor pollicis brevis; bid, twice daily; CRPS, complex regional pain syndrome; FDI, first dorsal interosseus muscle; GTC, generalized tonic clonic seizure; ITI, intertrain interval; MEP, motor evoked potential; MT, motor threshold; NR, not reported; qd, once daily

Reference Age/Sex Seizure Details Coil Location Stimulation Medical History Medications
Nowak DA, et al. (2006) 27y M

  • Right versive seizure with epigastric aura (epigastricdiscomfort followed by loss of consciousness with head and eye version to right, for 5 secs, and generalized tonic stiffening for 10 secs)

  • No incontinence

  • 10 sec postictal unresponsiveness

  • Complete amnesia for event

 Over left primary auditory cortex 5 days of 1 train per day (1 Hz × 18 min) = 1080 pulses/day @ 90% MT

  • Mono-auricular tinnitus

  • Otherwise unremarkable medical history

 None
Rosa MA, et al. (2006) 24y F

  • GTC (initial tonic phase for 8 seconds, followed by clonic movements for about 3 min).

  • Heart rate elevation.

  • No incontinence.

  • 10 min postictal confusion.

  • Complete amnesia for event.

  • Oxygenation was provided and intravenous medication access was achieved but occurred after seizure had ended.

  • Seizure occurred on the 5th day of stimulation during the 10th session.

 Left motor cortex, as defined by optimal position for induction of MEPs in the ABP. 5 days of 25 trains per day (10 Hz × 10s; 20s ITI) = 2500 pulses/day @ 100% MT

  • CRPS

  • Had previous surgical neurovascular decompression by supraclavicular approach for a thoracic outlet syndrome.

  • Otherwise unremarkable medical history

 NR
Picarelli H, et al (2010) >22y Sex NR

  • GTC (no focal onset, lasting 15 seconds)

  • Mild post-ictal confusion lasting 15 minutes.

  • Following seizure there were no motor deficits, head CT and EEG were normal.

  • Seizure occurred on the 7th day of stimulation.

 Left motor cortex, as defined by optimal position for induction of MEPs in the FDI. 10 days of (25 trains (10 Hz × 10s w/60s ITI) = 2500 pulses/day @ 100% RMT

  • CRPS

  • Physical therapy program (kinesiotherapy plus low impact, aerobic, relaxation and stretching exercises)

  • No history of seizure or epileptic disorders.

  • naproxen 250mg bid

  • amitriptyline 50mg qd

  • carbamazepine 200 mg bid