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Background: Epileptic seizures are resistant to pharmacotherapy in approximately 1/3 of all instances, a statistic
that has not changed despite the introduction of >20 new antiepileptic drugs in the late twentieth and early twentyfirst
century. Accordingly, neuromodulation protocols are emerging as potentially valuable tools for seizure control.
In focal epilepsy, the capacity of cathodal transcranial direct current polarisation to reduce cortical excitability has
prompted research into this technique’s antiepileptic potential. Purpose to investigate whether cathodal transcranial
direct current polarisation can modify seizure frequency in drug resistant focal epilepsy patients assessed by clinical
evaluation, seizure diary and electroencephalography.
Methods: A randomized, double blind, placebo controlled clinical trial on 20 patients diagnosed with multidrug
resistant focal epilepsy was enrolled in our study. The patients were randomized into 2 groups. Group A received
real 5-day sessions of cathodal tdcs over the area of most frequent interictal epileptiform discharges or the area of
suspected ictal onset inferred by MRI findings, ictal EEG and clinical seizure semiology. Group B received sham
sessions. Outcome indicators were baseline and post sessions seizure diary as well as EEG (epileptiform discharges
were counted per hour).
Results: There were no significant differences in age and gender between patients and controls (p> 0.05). The
percentage reduction of epileptiform discharges was greater for real stimulation group versus the placebo group (p=
0.0124). In addition, the percentage reduction of seizure frequency was greater for real stimulation group versus the
placebo group (p= 0.0308). It is noted that cathodal direct current stimulation can improve control of focal drug
resistant epilepsy patients. Conclusion our study shows that cathodal tdcs is a promising therapeutic tool for short
term seizure reduction in chronic drug resistant focal epilepsy patients.
Biography
Ann Ali Abdelkader Hanafy has completed her MD at the age of 30 years from Cairo University and postdoctoral studies from Cairo University School of Medicine. She is a Professor of Clinical neurophysiology & the President of Egyptian Clinical Neurophysiology Society. She has published more than 100 papers in local and international journals.
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