{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:18:33Z","timestamp":1783682313859,"version":"3.55.0"},"reference-count":18,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,26]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Super-refractory status epilepticus (SRSE) during pregnancy is a rare, life-threatening condition with limited therapeutic options. Transcranial focal current stimulation (TFS) has shown benefit in refractory epilepsy, but its use in SRSE during pregnancy has not been reported. We describe a woman in her 20s at 12 weeks\u2019 gestation with longstanding focal drug-resistant epilepsy who developed SRSE despite escalation of antiseizure medications and multiple intravenous anaesthetic regimens, requiring prolonged intensive care and mechanical ventilation. Neuroimaging revealed frontal gliotic lesions, and continuous electroencephalographic monitoring demonstrated persistent ictal activity, guiding subsequent therapeutic interventions. After multidisciplinary discussion and informed consent, TFS was administered over two consecutive days. No maternal or fetal adverse effects were observed, seizure activity resolved and sedation was successfully withdrawn with neurological recovery. The pregnancy progressed without complications and a healthy neonate was delivered at 38 weeks. TFS was temporally associated with resolution of SRSE without maternal or fetal adverse effects.<\/jats:p>","DOI":"10.1136\/bcr-2026-273014","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:10:13Z","timestamp":1783681813000},"page":"e273014","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transcranial focal current stimulation in super-refractory status epilepticus in a pregnant patient"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-5851","authenticated-orcid":false,"given":"Daniel","family":"San-Juan","sequence":"first","affiliation":[{"name":"Epilepsy Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"},{"name":"Epilepsy Clinic, Hospital Angeles Pedregal, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A","family":"Zepeda-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Padilla-Cabezutd","sequence":"additional","affiliation":[{"name":"Epilepsy Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"},{"name":"Epilepsy Clinic, Hospital Angeles Pedregal, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazmin","family":"Palomares-Salazar","sequence":"additional","affiliation":[{"name":"Epilepsy Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Cruz-Perez","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4191-9819","authenticated-orcid":false,"given":"Ximena","family":"Blasco","sequence":"additional","affiliation":[{"name":"Epilepsy Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9737-0529","authenticated-orcid":false,"given":"Emilio","family":"Garc\u00eda G\u00f3mez","sequence":"additional","affiliation":[{"name":"Epilepsy Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Besio","sequence":"additional","affiliation":[{"name":"Department of Electrical, Computer, and Biomedical Engineering, University of Rhode Island, Kingston, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"2026071004100856000_19.7.e273014.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70187-9"},{"key":"2026071004100856000_19.7.e273014.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02130.x"},{"key":"2026071004100856000_19.7.e273014.3","doi-asserted-by":"publisher","DOI":"10.1177\/1756285615623934"},{"key":"2026071004100856000_19.7.e273014.4","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1111\/j.1528-1167.2007.01202.x","article-title":"Effects of noninvasive transcutaneous electrical stimulation via concentric ring electrodes on pilocarpine-induced status epilepticus in rats","volume":"48","author":"Besio","year":"2007","journal-title":"Epilepsia"},{"key":"2026071004100856000_19.7.e273014.5","doi-asserted-by":"crossref","DOI":"10.3390\/ph14080706","article-title":"Transcranial Focal Electrical Stimulation Modifies Biogenic Amines\u2019 Alterations Induced by 6-Hydroxydopamine in Rat Brain","volume":"14","author":"Santana-G\u00f3mez","year":"2021","journal-title":"Pharmaceuticals (Basel)"},{"key":"2026071004100856000_19.7.e273014.6","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13121"},{"key":"2026071004100856000_19.7.e273014.7","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.yebeh.2017.07.002","article-title":"Status epilepticus in pregnancy: Etiology, management, and clinical outcomes","volume":"76","author":"Rajiv","year":"2017","journal-title":"Epilepsy Behav"},{"key":"2026071004100856000_19.7.e273014.8","doi-asserted-by":"crossref","DOI":"10.3389\/fnsys.2022.827353","article-title":"Entrainment and Spike-Timing Dependent Plasticity - 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