癫痫患者经颅磁刺激的安全性观察

目的：评估癫痫患者经颅磁刺激（ＴＭＳ）的安全性。方法：以单脉冲磁刺激检测３５例癫痫患者和３０例对照组的双侧运动传导通路，依次刺激肘部，锁骨上窝，第７颈椎和运动皮质诸部位，周围段刺激间隔≥３秒，皮质刺激间隔≥１０秒，每部位刺激总数≤１２次，记录运动诱发电位（ＭＥＰ）。结果：测试过程中患者和对照组均未出现癫痫发作，随访部分患者２～４周，其测试前后的发作形式和频率未发生改变，个别患者在刺激时有短暂轻微不适；患者的皮质刺激阈强度均高于对照组，经抗癫痫治疗者增高更明显。结论：单脉冲磁刺激对癫痫患者是一种安全的电生理检测手段，可应用于研究癫痫的病理生理，指导抗癫痫药物的应用

Study on safety of transcranial magnetic stimulation in patients with epilepsy.

Objectives: To assess the safety of transcranial magnetic stimulation (TMS) in epileptics. Methods: The bilateral motor conduction pathways were stimulated by singlepulse TMS at the elbow, the supraclavicular fossa, the 7th vertebra and the motor cortex successively in 35 patients with epilepsy and 30 controls. The interval of peripheral stimulation was 3 sec, cortical stimulation 10 sec and the total stimulation for each site was 12 times. Motor evoked potential (MEP) was recorded. Results: No seizures occurred during magnetic stimulation in all subjects. No changes in frequency and type of seizures were observed during 24 week followup.Only individual patients felt brief and mild discomfort during magnetic stimulation. The threshold intensity of cortical stimulation was increased significantly in all patients, especially in those with antiepileptic treatment as compared with the control. Conclusions: Singlepulse TMS might be a safe and useful electrophysiological determination for epileptic patients and it could be used to study the pathophysiology of epilepsy and to direct the application of antiepileptic drugs.