Contraindications

The TMS Committee of the International Federation of Clinical Neurophysiology suggests when TMS should not be used:

• Metal anywhere in the head, excluding the mouth, is generally a contraindication to TMS. This includes shrapnel, and screws and clips from surgical procedures unless the physical properties of the metal object(s) are known and there is a strong reason for using TMS.

• TMS also should not be performed in patients with electrodes inside the heart which might provide a low-resistance current path to electrically sensitive tissue.

• Persons with serious heart disease are at increased risk in the event of a seizure, and unless the potential clinical benefit outweighs the risk, they should not participate in TMS studies.

• Persons with increased intracranial pressure, as in acute large infarctions or trauma, are also at increased risk in the event of a seizure, and should not receive TMS.

• Pregnant women or women of child bearing age who might be pregnant should also be excluded from TMS studies.

• Finally, great caution is needed when applying TMS to subjects with a history of seizures, a family history of epilepsy, and patients taking medication that might increase the risk of seizures.