Magnetic facial nerve stimulation in animal models of active seizure

- Magnetic stimulation directed at the facial nerve does not worsen epileptiform activity at parameters that increase cerebral blood flow.
- Magnetic stimulation directed at the facial nerve may reduce the severity of ongoing epileptiform activity at certain stimulation parameters.
- These observations are consistent across two established animal models of activity seizures.

PurposeAs part of our efforts to develop a non-invasive facial nerve stimulator as an emergency treatment for ischemic stroke, we considered possible safety consequences if the technology was misapplied to stroke mimics, e.g., seizure. We hypothesized that magnetic facial nerve stimulation would worsen epileptiform activity in two animal models of active seizures. The rat intraperitoneal kainate model and pig intracortical penicillin model were employed. Magnetic facial nerve stimulation was delivered unilaterally at a variety of stimulation parameters, and the effect on ictal epileptiform activity measured by electroencephalography was determined according to an established categorical scale.Principal resultsIn 6 rats and 3 pigs evaluated with 83 stimulation trials, only a single stimulation trial was associated with worsening epileptiform activity according to a standard categorization scheme. Surprisingly, a reduction in the severity of the epileptiform activity was observed in 20 of 50 stimulation trials using patterned stimulation (3 pulses at 30 Hz repeated at 0.5-10 Hz) versus 2 of 33 stimulation trials using simple monotonic patterns (P < 0.005, chi-squared test). The reduction of epileptiform activity after stimulation lasted a few minutes and was reproducible.Major Conclusions Epileptiform activity measured by electroencephalography was not reliably worsened by repetitive facial nerve stimulation with pulsed magnetic energy, even when significant brain exposure to the magnetic field occurred as in the rat model. To the contrary, a temporary reduction in epileptiform activity was often, but not invariably, observed with certain stimulation parameters.

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