rTMS Reduces Seizures in Drug-Resistant Canine Epilepsy: A Small Sham-Controlled Trial

TL;DR

A small single-blinded sham-controlled trial reports that a three-day repetitive transcranial magnetic stimulation (rTMS) protocol reduced seizure frequency and cluster seizures in dogs with drug-resistant idiopathic epilepsy, with no adverse events.

What just dropped

• Charalambous and colleagues (2025) published a single-blinded, randomized, sham-controlled clinical trial of a novel three-day rTMS protocol in 20 dogs with drug-resistant idiopathic epilepsy or epilepsy of unknown origin, allocated to active (n=10) or sham (n=10) stimulation. Source: https://europepmc.org/articles/PMC12366470
• Median monthly seizure frequency was lower in the active group (8, range 0-24) than the sham group (17, range 7-46; p=0.04), as was monthly seizure day frequency (active 8 vs sham 11; p=0.04). Source: https://europepmc.org/articles/PMC12366470
• The number of cluster seizures was significantly lower with active rTMS (10, range 5-23) versus sham (16, range 10-25; p=0.005), and no adverse events were reported. Source: https://europepmc.org/articles/PMC12366470

Context

Roughly a third of dogs with idiopathic epilepsy remain inadequately controlled on antiseizure drugs, which has driven interest in non-pharmacologic adjuncts. The same drug-resistant population was the focus of the 51-dog cannabidiol crossover trial, where dogs had to have at least two seizures per month while receiving at least one antiseizure drug, underscoring how much unmet need persists in this group. Against that backdrop, rTMS is a non-invasive neurostimulation technique borrowed from human epilepsy practice.

The authors caution that a one-size-fits-all rTMS protocol is likely to give suboptimal results because the effect depends heavily on stimulation parameters and individual variability. This is a small pilot-scale trial, so the findings are best read as a proof-of-concept safety and signal study rather than a practice-changing result.

What this changes in the canine epilepsy toolkit

For clinicians managing dogs whose seizures break through conventional antiseizure therapy (see the levetiracetam evergreen at https://www.thevoyage.ai/forvets/knowledge/levetiracetam-canine-epilepsy), rTMS adds an early, device-based option to the research conversation about drug-resistant epilepsy. It does not yet have a standardized protocol or large-trial validation, and it should be framed to clients as investigational. The takeaway for now is that the safety signal was clean and the seizure-burden reduction was statistically significant in this small controlled study.

References

1. Charalambous M, Hunting D, Meyerhoff N, Twele F, Meller S, Volk HA. 2025. Application of a novel three-day repetitive transcranial magnetic stimulation protocol for the treatment of drug-resistant epilepsy in dogs: single-blinded randomised sham-controlled clinical trial. Front Vet Sci. https://europepmc.org/articles/PMC12366470
2. Rozental AJ, Weisbeck BG, Corsato Alvarenga I, et al. 2023. The efficacy and safety of cannabidiol as adjunct treatment for drug-resistant idiopathic epilepsy in 51 dogs: A double-blinded crossover study. J Vet Intern Med. https://europepmc.org/articles/PMC10658598

Voyage Clinical Desk

From clinical question to SOAP draft — cited differentials, live dose calculators, owner handouts. Trained on the veterinary canon (Plumb's, Ettinger, JVIM, ACVIM consensus, 50,000+ indexed references). First answer free, no signup.

Open Voyage Clinical Desk: https://www.thevoyage.ai/forvets/ask?context=update-2026-06-20-rtms-drug-resistant-epilepsy-dogs

Related reads

• Levetiracetam for Canine Idiopathic Epilepsy: Comparative Outcomes, Serum Monitoring, and Intranasal Emergency Use
• Cannabidiol Canine Epilepsy