Transcranial Magnetic Stimulation (TMS)

The transcranial magnetic stimulation (TMS) laboratory at Dell Children’s Medical Center provides advanced noninvasive brain-mapping technology used to gather clinical measurements of neuronal (brain cell) excitability.

What is transcranial magnetic stimulation?

TMS is a noninvasive (requiring no surgery, shots, or radiation) “brain-mapping” technology that can identify the exact location of essential brain functions, such as those involved in controlling the hands and feet or speech production. TMS uses a magnet that delivers a series of focused magnetic pulses to a specific brain region. The pulses stimulate that area of the brain and allow your child’s doctor to determine what that region of the brain is used for. This procedure’s results are compared with your child’s MRI results to create a “functional brain map” that will help your child’s doctor develop an appropriate treatment plan. Using this information, surgeons can remove diseased brain tissue while minimizing damage to parts of the brain that are working properly.

Why is transcranial magnetic stimulation performed?

TMS may be performed for people with chronic neurological problems as well as those who may need brain surgery.

TMS may be beneficial to:

• Children with medically refractory epilepsy (drug-resistant epilepsy)
• Patients diagnosed with a brain tumor
• Any patient who has consulted with a neurologist and neurosurgeon about brain surgery
• Patients with depression

What can I expect during transcranial magnetic stimulation?

The amount of time it takes to complete a TMS procedure varies from person to person. However, you should be prepared for the process to take anywhere between 1 and 2 hours. During this time, there will be long stretches where your child will be asked to remain still, but there will be opportunities for breaks. Young children, or those who cannot lie still, may need to be sedated or given general anesthesia, which may involve additional time commitments. This will be determined by your child’s doctor.

During TMS treatment, your child will be seated in a reclining chair, and a technician will position them appropriately beneath a handheld device. Your child may also have electrodes placed on their arms or legs, depending on their doctor’s recommendations. The TMS machine produces a magnetic field that is directed to specific areas of the brain by the handheld device. This temporarily stimulates the areas without causing a seizure or requiring anesthesia. The machine will make a clicking sound each time the brain is stimulated, and the stimulation may cause your child’s hands or feet to twitch. Once the procedure has been completed, the technician will come to help your child out of the chair.

How can I best prepare for transcranial magnetic stimulation?

TMS is an outpatient procedure that is often well tolerated and requires minimal preparation. Your child can eat before the procedure as they normally would, and they should take any medications as usual unless told otherwise. Because TMS uses magnetic fields to stimulate the brain, certain metallic or electronic implants may be affected. Please notify the TMS department personnel in advance if your child has an electronic implant, such as a vagus nerve stimulator (VNS) or pacemaker.

Other ways you can prepare for a TMS scan may include:

• Make sure your child avoids caffeinated drinks (e.g., soda, coffee, tea) the morning of the procedure

• Wash your child’s hair the night before and avoid any hair products, including conditioner, gel, mousse, oils, and hairspray

• Remove their glasses before the procedure; contact lenses can be worn

• Bring a blanket or stuffed animal to comfort your child during the procedure

Care Team Approach

UT Health Austin Pediatric Neurosciences at Dell Children’s, a clinical partnership between Dell Children’s Medical Center and UT Health Austin, takes a multidisciplinary approach to your child’s care. This means your child and your family will benefit from the expertise of multiple specialists across a variety of disciplines. Your child’s care team will include epileptologists, pediatric neurologists, pediatric neuropsychologists, pediatric neurosurgeons, pediatric physical medicine and rehabilitation specialists, hospitalists, anesthesiologists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical therapists, occupational therapists, speech therapists, neurodiagnostic technicians, pharmacists, and more, who work together to provide unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your child’s care with their other healthcare providers to ensure that we are providing comprehensive, whole-person care.

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