Transcranial magnetic stimulation induces 'pseudoabsence seizure'

Objective: Several studies support the hypothesis of an antidepressive or m ood-enhancing effect of repetitive transcranial magnetic stimulation (rTMS) on depressive patients. The most acute concern regarding rTMS is possible seizure induction; therefore, reports on seizure during rTMS are of special significance. Method: We describe a case in which high frequency rTMS over the left dorso latero-prefrontal cortex (DLPC) applied as an add-on antidepressive strateg y may have induced a frontal lobe complex partial seizure in a female patie nt affected by drug-resistant depression. Results: The epileptic seizure was self-limited, and the patient did not re port any physical sequelae. The psychopathological improvement, observed im mediately after the incident in question, did not last. Conclusion: In this case train duration in rTMS, combined with drugs modula ting the norepinephrine turnover, may have contributed to the occurrence of this complex partial seizure, which neuroanatomically seems to be localize d in the DLPC.