OBJECTIVE: Epilepsy is determined by an altered balance between excitatory and inhibitory influences at the cortical level. Therefore, methods that can restablish this normal balance are warranted to improve epilepsy treatment. Transcranial magnetic stimulation (TMS) is a noninvasive procedure that can modulate the cortical excitability. This review analyzes the current role of TMS in the treatment of refractory epilepsy. METHODS: MEDLINE was used as a database to review pertinent articles and abstracts. RESULTS: Treatment with rTMS (repetitive TMS) in patients with refractory epilepsy is safe and may benefit patients without surgical indication. Although there are few randomized studies with homogeneous groups of patients, there are evidences that patients with neocortical lesions will have more benefits from this technique than those with mesial lesions, which may represent a limitation of this non-invasive procedure. CONCLUSION: TMS may represent an important therapeutic tool for patients with refractory epilepsy without surgical indication, especially those with neocortical lesions, as it is non-invasive and safe treatment.
transcranial magnetic stimulation; epilepsy; treatment
