Role of Low Frequency Repetitive Trans Cranial Magnetic Stimulation in Drug Resistant Epilepsy Clinical, Laboratory and Neurophysiology Study
Mohamed Abd Elwaged, A., Masoud, H., El-bialy Elsharkawy, R., Younes Abdelaziz, S. (2025). Role of Low Frequency Repetitive Trans Cranial Magnetic Stimulation in Drug Resistant Epilepsy Clinical, Laboratory and Neurophysiology Study. EKB Journal Management System, (), -. doi: 10.21608/ijma.2025.390893.2195
Asmaa Mohamed Abd Elwaged; Hoda M Masoud; Rasha El-bialy Elsharkawy; Sarah Younes Abdelaziz. "Role of Low Frequency Repetitive Trans Cranial Magnetic Stimulation in Drug Resistant Epilepsy Clinical, Laboratory and Neurophysiology Study". EKB Journal Management System, , , 2025, -. doi: 10.21608/ijma.2025.390893.2195
Mohamed Abd Elwaged, A., Masoud, H., El-bialy Elsharkawy, R., Younes Abdelaziz, S. (2025). 'Role of Low Frequency Repetitive Trans Cranial Magnetic Stimulation in Drug Resistant Epilepsy Clinical, Laboratory and Neurophysiology Study', EKB Journal Management System, (), pp. -. doi: 10.21608/ijma.2025.390893.2195
Mohamed Abd Elwaged, A., Masoud, H., El-bialy Elsharkawy, R., Younes Abdelaziz, S. Role of Low Frequency Repetitive Trans Cranial Magnetic Stimulation in Drug Resistant Epilepsy Clinical, Laboratory and Neurophysiology Study. EKB Journal Management System, 2025; (): -. doi: 10.21608/ijma.2025.390893.2195

Role of Low Frequency Repetitive Trans Cranial Magnetic Stimulation in Drug Resistant Epilepsy Clinical, Laboratory and Neurophysiology Study

International Journal of Medical Arts
Articles in Press, Accepted Manuscript, Available Online from 29 September 2025
Document Type: Original Article
DOI: 10.21608/ijma.2025.390893.2195
Authors
Asmaa Mohamed Abd Elwaged* 1; Hoda M Masoud1; Rasha El-bialy Elsharkawy1; Sarah Younes Abdelaziz2
1Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
2Department of Clinical Pathology, Faculty of Medicine for Girls, Cairo, Egypt.
Abstract
Background

Drug-resistant epilepsy (DRE) poses significant challenges in management, affecting a huge number of epileptic patients despite the availability of antiepileptic medications. This study investigates the efficacy of Low Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) as a therapeutic technique for DRE.

Objective

To evaluate the impact of rTMS on seizure frequency, severity, and associated biomarkers in patients with DRE.

Methods

A total of 45 participants were enrolled, divided into two groups: 23 cases receiving active rTMS and 22 sham controls. The study employed a randomized, double-blind design. Seizure frequency and severity were assessed using the Chalfont Seizure Severity Scale (CSSS) before and six weeks’ post-intervention

Results

The active rTMS group demonstrated a significant decrease in seizure severity (mean change: 32.39 ± 9.10, p < 0.001) and frequency (mean change: 8.00 ± 2.40, p < 0.001) compared to the sham group. Additionally, HMGB1 levels decreased significantly in the rTMS group (mean change: 11.25 ± 1.72, p < 0.001), while the sham group showed a lesser reduction (mean change: 5.36 ± 1.39, p = 0.037). Correlation analysis revealed a significant relationship between the reduction in seizure severity and HMGB1 levels (r = 0.509, p = 0.006).

Conclusion

Low-frequency rTMS effectively reduces seizure frequency and severity in patients with DRE. The findings suggest a potential biomarker (HMGB1) associated with treatment response, warranting further investigation into the mechanisms underlying rTMS efficacy in epilepsy management.
Keywords
psychology; neurology; neurosuregry
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