TMS-Induced Seizure during FDA-Approved Bilateral DMPFC Protocol for Treating OCD: A Case Report

Georgios Mikellides*, Panayiota Michael, Teresa Schuhmann, Alexander T. Sack

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that has become a method of choice for the treatment of several neuropsychiatric disorders such as depression and OCD. It is considered to be a safe and well-tolerated treatment, with only few side effects. The most serious adverse event during any rTMS treatment is the potential induction of a seizure. rTMS has shown very encouraging results for treatment-resistant OCD, although the optimal target area and the stimulation frequency are still matters of controversy. Here, we present a 19-year-old female patient with OCD who experienced seizure during the 7th session of her rTMS treatment using the FDA-approved 20-Hz protocol for OCD applied bilaterally over the left and right DMPFC using a double-cone coil. Nonetheless, it still unknown whether the seizure occurred as a consequence of rTMS, as the patient was also in a specific seizure risk group. Future reviews are needed to further clarify the mechanisms that may trigger seizures during rTMS treatments in order to reduce the likelihood of rTMS-induced seizures.

Original languageEnglish
Pages (from-to)584-590
Number of pages7
JournalCase Reports in Neurology
Issue number3
Publication statusPublished - 28 Oct 2021


  • Deep brain stimulation
  • Dorsomedial prefrontal cortex
  • High-frequency repetitive transcranial magnetic stimulation
  • Obsessive-compulsive disorder
  • RTMS
  • Repetitive transcranial magnetic stimulation
  • Seizure induction
  • Transcranial magnetic stimulation-induced seizure


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