title: Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy.
abstract: BACKGROUND
  Cathodal transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation method for suppressing regional cortical excitability. We examine the safety and antiepileptic efficacy of cathodal tDCS in children with refractory focal epilepsy. Although a prior cathodal tDCS trial in adults with epilepsy revealed EEG improvement, neither the antiepileptic potential nor the safety and tolerability of tDCS has been tested in children.
  
  
  METHODS
  The study consisted of three phases: 1) a 4-week pre-treatment monitoring period with vital sign measures, EEG, seizure diary, and baseline quality of life (QOL) questionnaire; 2) a single treatment with 1 mA cathodal tDCS for 20 min with cathode positioned over the seizure focus and anode on the contralateral shoulder; 3) follow-ups immediately after stimulation, and at 24, 48 h, and 4 weeks after tDCS with continued seizure diary and epileptic discharge counts on EEG; the QOL questionnaire was also repeated 4 weeks after stimulation. Patients were randomized to receive either single session active or sham tDCS 1 mA, 20 min.
  
  
  RESULTS
  Thirty six children (6-15 years) with focal epilepsy were enrolled, 27 in active and 9 in sham group. All patients tolerated tDCS well. No serious adverse events occurred. Active tDCS treatment was associated with significant reductions in epileptic discharge frequency immediately and 24 and 48 h after tDCS. Four weeks after treatment, a small (clinically negligible but statistically significant) decrease in seizure frequency was also detected.
  
  
  CONCLUSIONS
  A single session of cathodal tDCS improves epileptic EEG abnormalities for 48 h and is well-tolerated in children.
authors: Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
authors: Narong
authors: N
authors: Auvichayapat
authors: Alexander
authors: A
authors: Rotenberg
authors: Roman
authors: R
authors: Gersner
authors: Sudarat
authors: S
authors: Ngodklang
authors: Somsak
authors: S
authors: Tiamkao
authors: Wichittra
authors: W
authors: Tassaneeyakul
authors: Paradee
authors: P
authors: Auvichayapat
mesh_terms: D000293:Adolescent; D001921:Brain / Q000503:physiopathology*; D002648:Child; D004599:Electric Stimulation Therapy / Q000379:methods*; D004828:Epilepsies, Partial / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Clinical neurophysiology; Focal seizures; Noninvasive brain stimulation; Partial seizures; Transcranial direct current stimulation