Transcranial Direct Current Stimulation For Treatment Of Refractory Temporal Lobe Epilepsy: A Scoping Review

Introduction: Neuromodulation devices have emerged as an alternative treatment for drug-resistant epilepsy syndrome, especially for temporal lobe epilepsy (TLE). Transcranial direct current stimulation (tDCS) is one of neuromodulation techniques that shown promising results in refractory epilepsy. We aim to evaluate clinical efficacy of tDCS used in refractory TLE in clinical trial setting. Methods: Six-stages Arksey and O'Malley's methodology framework were used to guide this scoping review. PubMed, SCOPUS, and Cochrane Library were searched for clinical trials involving tDCS in refractory TLE. We also examined the tDCS protocol used, clinical efficacy and its side effects. Results: Five studies met the inclusion criteria. Three studies were randomized crossover studies, and the other two were randomized placebo-controlled double-blind study and pilot randomized control trial. A total of 85 subjects were involved with mean seizure frequency of 2.6 per week. TDCS protocols involved were 1 and 2 mA of direct current with varying frequency and duration. All studies showed improved seizure control in TDCS arm with minimal to zero side effects. Conclusion: TDCS appears as a safe and better option. Despite the benefit seen among refractory TLE, future prospective studies should focus on standardization of tDCS application as well as a more homogenous patient selection.