Evaluating the efficacy of non-invasive brain stimulation techniques in managing pediatric epilepsy

Background: Pediatric epilepsy significantly affects cognitive and developmental outcomes, with drug-resistant epilepsy (DRE) posing a major challenge. While pharmacological and surgical interventions remain standard treatments, they often fail in refractory cases. Non-Invasive Brain Stimulation (NIBS), including Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), has emerged as a promising therapeutic alternative. New method: This study systematically reviews and compares the efficacy, safety, and feasibility of TMS and tDCS in pediatric epilepsy. The analysis evaluates seizure reduction, cognitive improvements, and treatment tolerability. A comparative assessment considers mechanisms of action, precision, accessibility, and clinical applications. Results: TMS and tDCS treatments produce a 30-40 % seizure reduction effect in addition to attaining enhanced attention and memory functions. TMS provides top-level spatial precision but tDCS allows low-cost portable treatment that suits home use. Studies show that patients experience minimal and short-term discomfort on their scalp but only minor headaches as reported side effects. Comparison with existing methods: Compared to pharmacological treatments, NIBS offers a non-invasive alternative with fewer systemic side effects. Unlike surgery, which requires invasive intervention, NIBS is safe, repeatable, and adaptable. However, cost (TMS), lack of standardization, and patient response variability remain challenges to clinical adoption. Conclusions: NIBS is a safe and effective alternative for pediatric epilepsy but requires protocol standardization, accessibility improvements, and long-term efficacy validation. Future research should focus on biomarker-driven personalized treatments, AI-optimized stimulation, and affordable device development for broader clinical applications.