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High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

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High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

Brain Inj. 2018;32(1):135-143

Authors: Meiron O, Gale R, Namestnic J, Bennet-Back O, David J, Gebodh N, Adair D, Esmaeilpour Z, Bikson M

Abstract
PRIMARY OBJECTIVE: Early onset epileptic encephalopathy is characterized by high daily seizure-frequency, multifocal epileptic discharges, severe psychomotor retardation, and death at infancy. Currently, there are no effective treatments to alleviate seizure frequency and high-voltage epileptic discharges in these catastrophic epilepsy cases. The current study examined the safety and feasibility of High-Definition transcranial direct current stimulation (HD-tDCS) in reducing epileptiform activity in a 30-month-old child suffering from early onset epileptic encephalopathy.
DESIGN AND METHODS: HD-tDCS was administered over 10 intervention days spanning two weeks including pre- and post-intervention video-EEG monitoring.
RESULTS: There were no serious adverse events or side effects related to the HD-tDCS intervention. Frequency of clinical seizures was not significantly reduced. However, interictal sharp wave amplitudes were significantly lower during the post-intervention period versus baseline. Vital signs and blood biochemistry remained stable throughout the entire study.
CONCLUSIONS: These exploratory findings support the safety and feasibility of 4 × 1 HD-tDCS in early onset epileptic encephalopathy and provide the first evidence of HD-tDCS effects on paroxysmal EEG features in electroclinical cases under the age of 36 months. Extending HD-tDCS treatment may enhance electrographic findings and clinical effects.

PMID: 29156988 [PubMed – indexed for MEDLINE]

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