ERT Epilepsy Research and Treatment 2090-1356 2090-1348 Hindawi Publishing Corporation 10.1155/2015/678074 678074 Review Article Transcranial Magnetic Stimulation for Status Epilepticus Zeiler F. A. umzeiler@cc.umanitoba.ca 1 Matuszczak M. matuszcm@myumanitoba.ca 2 Teitelbaum J. jteitelbaum@hotmail.com 3 Gillman L. M. gillmanlm@yahoo.ca 4,5 5 Kazina C. J. ckazina@exchange.hsc.mb.ca 1 Janszky József 1 Section of Neurosurgery Department of Surgery University of Manitoba Winnipeg MB Canada R3A 1R9 umanitoba.ca 2 Undergraduate Medicine University of Manitoba Winnipeg MB Canada R3A 1R9 umanitoba.ca 3 Section of Neurology Montreal Neurological Institute McGill Montreal QC Canada H3A 2B4 4 Section of Critical Care Medicine Department of Medicine University of Manitoba Winnipeg MB Canada R3A 1R9 umanitoba.ca 5 Section of General Surgery Department of Surgery University of Manitoba Winnipeg MB Canada R3A 1R9 umanitoba.ca 2015 22112015 2015 30 08 2015 19 10 2015 03 11 2015 2015 Copyright © 2015 F. A. Zeiler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background. Our goal was to perform a systematic review on the use of repetitive transcranial magnetic stimulation (rTMS) in the treatment of status epilepticus (SE) and refractory status epilepticus (RSE). Methods. MEDLINE, BIOSIS, EMBASE, Global Health, Healthstar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform, clinicaltrials.gov (inception to August 2015), and gray literature were searched. The strength of evidence was adjudicated using Oxford and GRADE methodology. Results. We identified 11 original articles. Twenty-one patients were described, with 13 adult and 8 pediatric. All studies were retrospective. Seizure reduction/control with rTMS occurred in 15 of the 21 patients (71.4%), with 5 (23.8%) and 10 (47.6%) displaying partial and complete responses, respectively. Seizures recurred after rTMS in 73.3% of the patients who had initially responded. All studies were an Oxford level 4, GRADE D level of evidence. Conclusions. Oxford level 4, GRADE D evidence exists to suggest a potential impact on seizure control with the use of rTMS for FSE and FRSE, though durability of the therapy is short-lived. Routine use of rTMS in this context cannot be recommended at this time. Further prospective study of this intervention is warranted.