H-Coil Repetitive Transcranial Magnetic Stimulation Induced Seizure in an Adult with Major Depression: A Case Report

Boes, Aaron D.; Stern, Adam P.; Bernstein, Margo; Hooker, Julia E; Connor, Ann; Press, Daniel Z.; Pascual‐Leone, Álvaro

doi:10.1016/j.brs.2016.04.013

Cited by 10 publications

(7 citation statements)

References 9 publications

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“…In the pivotal sham-controlled trial, 1 out of 101 patients had a seizure (Levkovitz et al 2015). A very recent case has been reported in the literature of a 27-year-old man with depression and anxiety who had a seizure during deep TMS treatment with an H-1 coil (Boes et al 2016). It should be noted that the patient had several other seizure risk factors, including multiple past head injuries, intake of a large amount of alcohol the night before treatment, and poor sleep the night before treatment.…”

Section: Discussionmentioning

confidence: 99%

Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression

Cullen

Jasberg

Nelson

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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Objective: Deep transcranial magnetic stimulation (TMS) with an H-1 coil was recently approved by the U.S. Food and Drug Administration (U.S. FDA) for treatment-resistant depression (TRD) in adults. Studies assessing the safety and effectiveness of deep TMS in adolescent TRD are lacking. The purpose of this brief report is to provide a case history of an adolescent enrolled in an investigational deep TMS protocol. Methods: A case history is described of the first participant of a sham-controlled clinical trial who had a seizure in the course of deep TMS with parameter settings extrapolated from the adult studies that led to US FDA approval (H-1 coil, 120% target stimulation intensity, 18 Hz, 55 trains of 2-second duration, total 1980 pulses). Results: The participant was a 17-year-old unmedicated female, with no significant medical history and no history of seizures or of drug or alcohol use. Brain magnetic resonance imaging showed no structural abnormalities. She initially received sham, which was well tolerated. During active treatment sessions, titration began at 85% of motor threshold (MT) and increased by 5% per day. Her weekly MT measurements were stable. On her first day of 120% MT (8th active treatment), during the 48th train, the participant had a generalized, tonic-clonic seizure that lasted 90 seconds and resolved spontaneously. She had an emergency medicine evaluation and was discharged home without anticonvulsant medications. There were no further seizures reported at a 6-month follow-up. Conclusions: We report a deep TMS-induced generalized tonic-clonic seizure in an adolescent with TRD participating in a clinical trial. Given the demonstrated benefits of deep TMS for adult TRD, research investigating its use in adolescents with TRD is an important area. However, in light of this experience, additional precautions for adolescents should be considered. We propose that further dose-finding investigations are needed to refine adolescent-specific parameters that may be safe and effective for treating adolescents with TRD with deep TMS.

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Section: Discussionmentioning

confidence: 99%

Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression

Cullen

Jasberg

Nelson

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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“…The most common side effects of rTMS in clinical settings include headache (5%–23%) and discomfort at the stimulus site (20%–40%), and the most severe side effect is the induction of seizures (Machii et al, 2006 ; Maizey et al, 2013 ; Wall et al, 2014 ; Dobek et al, 2015 ; Boes et al, 2016 ). Prikryl and Kucerova ( 2005 ) reported a case of generalized tonic clonic seizure in a patient with MDD receiving rTMS.…”

Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

Recent Advances in Non-invasive Brain Stimulation for Major Depressive Disorder

Shui

Sheng

et al. 2017

Front. Hum. Neurosci.

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Non-invasive brain stimulation (NBS) is a promising treatment for major depressive disorder (MDD), which is an affective processing disorder involving abnormal emotional processing. Many studies have shown that repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) over the prefrontal cortex can play a regulatory role in affective processing. Although the clinical efficacy of NBS in MDD has been demonstrated clinically, the precise mechanism of action remains unclear. Therefore, this review article summarizes the current status of NBS methods, including rTMS and tDCS, in the treatment of MDD. The article explores possible correlations between depressive symptoms and affective processing, highlighting the relevant affective processing mechanisms. Our review provides a reference for the safety and efficacy of NBS methods in the clinical treatment of MDD.

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“…#1 completed safely, Pt. #2 had an EEG seizure w/no clinical S/S at Tx 21 Boes et al 2016 41 H1 27 y/o male had generalized tonic-clonic seizure at Tx 12, Hx of alcohol use and 4 head injuries Muir et al 2019 31 H1 See description under TMS in Children/Adolescents TMS and Head Injuries w/o Seizures Fitzgerald et al 2011 42 Figure 8 41 y/o female with Hx of mild TBI, completed 20 Txs Kreuzer et al 2013 43 Figure 8 53 y/o male had severe tinnitus after TBI, completed 5 Tx series over 3 years Neville et al 2015 44 Figure 8 Double-blind study involving 36 pts. aged 18–60 y/o with Hx of TBI Nielson et al 2015 45 Figure 8 48 y/o male with Hx of severe TBI, finished 30 Txs; 90% lower risk of seizure if none w/in 2 years of injury Englander et al 2003 47 N/A CT scan results and neurosurgical procedures useful in determining risk for late posttraumatic seizures Koski et al 2015 48 Figure 8 Treated 12 pts.…”

Section: Methodsmentioning

confidence: 99%

“… Stultz et al 2019 55 H1 23 y/o male with Hx of 4 concussions TMS and Alcohol Use Tendler et al 2018 9 H1 6/31 pts. reviewed who had a seizure involved increased alcohol intake Boes et al 2016 41 H1 See description under TMS and TBI Chiramberro et al 2013 28 Figure 8 See description under TMS in Children/Adolescents TMS and Sleep Deprivation Nakken et al 2005 56 N/A Reported on 1677 pts. with epilepsy, those with generalized seizures report to be more sensitive to sleep deprivation Ferlisi & Shorvon 2014 57 N/A Pts.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

<p>Transcranial Magnetic Stimulation (TMS) Safety with Respect to Seizures: A Literature Review</p>

Stultz

Osburn

Burns

et al. 2020

NDT

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H-Coil Repetitive Transcranial Magnetic Stimulation Induced Seizure in an Adult with Major Depression: A Case Report

Cited by 10 publications

References 9 publications

Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression

Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression

Recent Advances in Non-invasive Brain Stimulation for Major Depressive Disorder

<p>Transcranial Magnetic Stimulation (TMS) Safety with Respect to Seizures: A Literature Review</p>

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