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Lookup NU author(s): Katrin Bangel, Dr Yi NgORCiD, Dr Albert Lim, Dr Naomi Thomas, Dr Stephan Jaiser, Dr Ming Lai, Professor Grainne Gorman, Dr Rhys ThomasORCiD, Emeritus Professor Doug Turnbull, Dr Andrew Schaefer, Professor Bobby McFarlandORCiD, Professor Mark Baker
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Copyright © 2026. Published by Elsevier Ltd. Background Pathogenic POLG variants produce an age-related progressive multi-system mitochondrial disorder, with neurologic manifestations that include focal onset seizures, stroke-like episodes, cerebellar ataxia, sensory neuronopathy, complex ophthalmoplegia and myopathy. Focal onset status epilepticus or epilepsia partialis continua (EPC) frequently occurs in patients with paediatric and early adulthood onset disease. Methods Between 2014 and 2020, we treated 15 episodes of drug-refractory focal epileptic status ( epilepsia partialis continua ) in 5 patients with POLG -related mitochondrial disease with cathodal transcranial direct current stimulation (tDCS). Here we describe the management of each episode of EPC, including the application of tDCS. Results Transcranial DCS, delivered for 20 min at 2 mA, once daily (minimum 3 days; maximum 14 days), as an adjunct to optimal standard medical care, was associated with a significant reduction (93% of episodes after 4.3 sessions) or a cessation of seizures (63% of episodes after 8.4 sessions). No major side effects of tDCS were noted. Conclusion Our findings support further exploration of tDCS as a potential adjunctive therapy for complex neurological challenges in mitochondrial disorders.
Author(s): Bangel KA, Ng Y, Lim A, Thomas NJP, Jaiser SR, Lai HM, Gorman GS, Thomas RH, Turnbull DM, Ramesh V, Schaefer AM, McFarland R, Baker MR
Publication type: Article
Publication status: Published
Journal: Seizure
Year: 2026
Pages: Epub ahead of print
Online publication date: 09/05/2026
Acceptance date: 06/05/2026
ISSN (print): 1059-1311
ISSN (electronic): 1532-2688
Publisher: W.B. Saunders Ltd
URL: https://doi.org/10.1016/j.seizure.2026.05.009
DOI: 10.1016/j.seizure.2026.05.009
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