title: Transcranial Magnetic Stimulation for Status Epilepticus.
abstract: Background. Our goal was to perform a systematic review on the use of repetitive transcranial magnetic stimulation (rTMS) in the treatment of status epilepticus (SE) and refractory status epilepticus (RSE). Methods. MEDLINE, BIOSIS, EMBASE, Global Health, Healthstar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform, clinicaltrials.gov (inception to August 2015), and gray literature were searched. The strength of evidence was adjudicated using Oxford and GRADE methodology. Results. We identified 11 original articles. Twenty-one patients were described, with 13 adult and 8 pediatric. All studies were retrospective. Seizure reduction/control with rTMS occurred in 15 of the 21 patients (71.4%), with 5 (23.8%) and 10 (47.6%) displaying partial and complete responses, respectively. Seizures recurred after rTMS in 73.3% of the patients who had initially responded. All studies were an Oxford level 4, GRADE D level of evidence. Conclusions. Oxford level 4, GRADE D evidence exists to suggest a potential impact on seizure control with the use of rTMS for FSE and FRSE, though durability of the therapy is short-lived. Routine use of rTMS in this context cannot be recommended at this time. Further prospective study of this intervention is warranted.
authors.affiliation: Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada R3A 1R9.
authors.forename: F A
authors.initials: FA
authors.lastname: Zeiler
authors.affiliation: Undergraduate Medicine, University of Manitoba, Winnipeg, MB, Canada R3A 1R9.
authors.forename: M
authors.initials: M
authors.lastname: Matuszczak
authors.affiliation: Section of Neurology, Montreal Neurological Institute, McGill, Montreal, QC, Canada H3A 2B4.
authors.forename: J
authors.initials: J
authors.lastname: Teitelbaum
authors.affiliation: Section of Critical Care Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada R3A 1R9 ; Section of General Surgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada R3A 1R9.
authors.forename: L M
authors.initials: LM
authors.lastname: Gillman
authors.affiliation: Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada R3A 1R9.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kazina