Patients with severe epilepsy can have seizures every day – sometimes waking up on the floor, not knowing what happened. For about 1 in 3 epilepsy patients, drugs are of no help. An implanted vagus nerve stimulator can sometimes control seizures, but often not. Surgically removing the excitable brain tissue can be curative, but often, too many areas of the brain are involved to effectively remove the entire seizure focus. Or the area causing the seizures is too close to a vital brain area – say, a memory or motor area – making surgery too risky.
Alex Rotenberg, a neurologist in Children’s Hospital Boston’s epilepsy program, has been having success with an experimental technique for this kind of disabling, treatment-resistant epilepsy. Known as repetitive transcranial magnetic stimulation (rTMS), it has helped a small number of patients with no other good options for controlling their seizures.