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. 2025 May 23;11(1):12.
doi: 10.1186/s42234-025-00175-8.

Continuous theta burst stimulation in the treatment of epilepsia partialis continua: a case series

Chloé Algoet  1 , Sofie Carrette  2 , Alfred Meurs  2 , Ann Mertens  2 , Dimitri Hemelsoet  2 , Paul Boon  2   3 , Kristl Vonck  2
Affiliations

Continuous theta burst stimulation in the treatment of epilepsia partialis continua: a case series

Chloé Algoet et al. Bioelectron Med. .

Abstract

Background: Epilepsia partialis continua (EPC) is a medication-resistant form of focal status epilepticus (SE), causing significant morbidity. This case series explored whether continuous theta burst stimulation (cTBS) could reduce seizure activity in patients with EPC.

Methods: Three patients with motor EPC (2M/1F) underwent an accelerated cTBS protocol over four consecutive days (five 40-s trains/day, 5Hz bursts, 3 pulses at 50Hz/burst). Stimulation targeted the epileptogenic zone using a figure-of-eight coil at 80% of the resting motor threshold. Electroencephalography (EEG) was conducted before and after each session. Seizure frequency, intensity, adverse events (AEs), seizure diaries, and follow-up data were assessed.

Results: cTBS did not interrupt EPC in any patient. One patient reported a 17% reduction in seizure frequency. Another noted mild improvement in shoulder jerks, and a third reported reduced arm tension, though without clinical confirmation. EEG showed no significant changes. One patient experienced seizures during stimulation, and another reported worsening of pre-existing headaches.

Conclusion: In this small case series, a four-day accelerated cTBS protocol did not yield clinically meaningful seizure control in EPC. Further research is needed to evaluate TMS and TBS in SE and EPC, where a significant treatment gap remains.

Keywords: Continuous theta burst stimulation; EPC; Epilepsia partialis continua; Neuromodulation; Repetitive transcranial magnetic stimulation; Status epilepticus.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the ethics committee of Ghent University Hospital and written informed consent was obtained from all participants prior to inclusion. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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