Last modified: 2014-04-03
Abstract
Introduction
tDCS is a non invasive, inexpensive and safe tool for neuromodulation. tDCS has been used in treatment of psychiatric disorders, pain and epilepsy. We report on a trial of tDCS in a child with refractory focal epilepsy (RFE).
Case report
A 3 year child with RFE, intractable to multiple AEDs and immunomodulation, on a glutein free diet for celiac disease, had tDCS over two weeks.
V-EEG was indicative of right centroparietal focus of seizure onset. MRI showed no definite focal lesion. Focal seizures with and without secondary generalisation occurred innumerable times per day.
Methodology
Cathodal tDCS was delivered using NeuroConn DC stimulator MC on four sessions per week for two weeks. There were no adverse effects and the child tolerated it well. V-EEG was undertaken before, during and after tDCS. The number of spikes, frequency of unilateral and bilateral spikes, the average maximum and minimum spike amplitude and the proportion of the EEG with spikes was evaluated for a duration of 5 minutes before, during and after tDCS. Seizure frequency was monitored by history.
Results:
tDCS resulted in a significant reduction in the spike burden on EEG. However there was no significant improvement in clinical seizures.
Conclusion
tDCS may play a therapeutic role in refractory childhood epilepsy. In our child tDCS reduced the amount of epileptiform activity on EEG, but did not have an impact on her clinical seizures. Further studies are required to investigate different protocols of stimulation and evaluate efficacy.
Keywords
References
References
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