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nTMS in Pediatrics: Special Issues and Solutions

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Navigated Transcranial Magnetic Stimulation in Neurosurgery

Abstract

Neurosurgical treatment of pediatric patients harbors specific considerations. Neocortical resective surgery is unique in the challenges of operating in the proximity of eloquent cortex, and in some diseases, such as focal intractable epilepsy, an appreciable fraction of neocortical resections are destined to be in the pediatric population. Using nTMS for motor and language mapping is becoming increasingly valued in pediatric presurgical planning. The nTMS technique has demonstrable utility for obtaining the information needed for localization of motor and language function in children, with minimal associated health risks and very little difficulty on behalf of the operator.

 This chapter outlines the special considerations for nTMS in pediatric patients, including modifications to equipment setups, stimulation intensities, and potential influence of antiepileptic medications. It moreover outlines the differences of nTMS compared to other functional mapping techniques in the pediatric population and provides practical information on how to work with children of any age in order to obtain optimal mapping results.

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Authors and Affiliations

  1. Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Harper Lee Kaye B.A. & Alexander Rotenberg M.D., Ph.D.

  2. Boston Children’s Hospital, F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Fegan, 9th Floor, Boston, MA, 02115, USA

    Harper Lee Kaye B.A. & Alexander Rotenberg M.D., Ph.D.

  3. Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Alexander Rotenberg M.D., Ph.D.

Authors
  1. Harper Lee Kaye B.A.
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  2. Alexander Rotenberg M.D., Ph.D.
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Corresponding author

Correspondence to Alexander Rotenberg M.D., Ph.D. .

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Editors and Affiliations

  1. TU München, Klinikum rechts der Isar , München, Germany

    Sandro M. Krieg

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Kaye, H.L., Rotenberg, A. (2017). nTMS in Pediatrics: Special Issues and Solutions. In: M. Krieg, S. (eds) Navigated Transcranial Magnetic Stimulation in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-54918-7_12

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  • DOI: https://doi.org/10.1007/978-3-319-54918-7_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54917-0

  • Online ISBN: 978-3-319-54918-7

  • eBook Packages: MedicineMedicine (R0)

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