Bilateral Orbitofrontal Repetitive Transcranial Magnetic Stimulation in Frontal Lobe Epilepsy: A Case Report

Abstract

Epilepsy is a common and severe neurological disorder affecting millions of people worldwide. Nowadays, antiseizure medications (ASMs) are the main treatment for most epilepsy patients, although many of them do not respond to ASMs and suffer from drug-resistant epilepsy (DRE). Alternative and novel treatment methods have been offered nowadays, showing promising results for the treatment of DRE. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method that has become increasingly popular in the last decades. This article reports a patient with frontal lobe epilepsy. We aimed to investigate whether bilateral orbitofrontal (OFC) low-frequency rTMS (LF-rTMS) is feasible and tolerable, safe, and potentially clinically effective in treating epileptic seizures. The patient’s satisfaction with rTMS therapy was self-reported to be high, as rTMS helped in reducing the frequency of the focal attacks and completely abolished the preceding feeling of fear and panic. Therefore, bilateral OFC rTMS treatment can be well tolerated in patients with frontal epilepsy although the findings of the present case report with regard to clinical efficacy warrant further investigation.

Keywords

• epilepsy
• drug-resistant epilepsy
• orbitofrontal cortex
• repetitive transcranial magnetic stimulation