A Non-Epileptiform Event in the Course of rTMS: A Case for Close Physician Monitoring

We present the following case to demonstrate the importance of having physician supervision of patients undergoing repetitive transcranial magnetic stimulation (rTMS) treatments. The patient was a married 60-year-old male with a diagnosis of Major Depressive Disorder and Generalized Anxiety Disorder who had continuous symptoms of depression since the early 1980s despite receiving at least 7 adequate antidepressant treatments. The patient had several comorbid medical conditions. The patient did not have any previous history of seizure, stroke, an abnormal EEG, head injury, neurosurgical procedure, implanted devices, frequent headaches, or a neurologic illness. In addition, there was no family history of epilepsy. The patient's medications included bupropion XL 300 mg, diazepam 10 mg every 8 hours as needed for anxiety, rosuvastatin, lisinopril, rosiglitazone/metformin, finasteride, ranitidine, and vitamins. The patient's level of depression was moderate with a Quick Inventory of Depressive Symptoms – Self Rated (QIDS-SR) score of 12 and significant impairment in work and social functioning.
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Tags: Letters to the Editor Source Type: research