Cerebellar RTMS in Patients with Multiple Sclerosis

Prior treatment

• Previous surgeries in the brain.
• Any magnetic or metallic devices implanted (like cochlear implants) .

Other illness

• Secondary musculoskeletal complication such as contractures or deformities. Cardiovascular, pulmonary, hepatic, renal, hemopoietic and thyroid diseases.
• Psychotic deficits or history of epileptic seizures.

Other

• Any other neurological deficits or orthopedics abnormalities.
• Ataxic manifestations for other cause rather than Multiple Sclerosis.
• Other neurological manifestations (e.g. spasticity, visual loss)
• Pregnant women.
• Addicted individuals.

• Clinically definite MS (relapsing, remitting and secondary progressive) patients
• Patients who are medically stable and Free from relapses three months before
• Ambulant patients without an assistive device and score less than 5 on the Kurtzke Expanded Disability Status Scale (EDSS)
• Patients receiving their disease modifying drugs but no medication changing during the previous three months.
• Patients who had MRI evidence of lesions in the cerebellum or in the cerebellar pedunculi.
• Right handed patients.
• Severity of ataxia range from 4 to 10 according to scale of assessment and rating ataxia (SARA).
• Did not apply cerebellar transcranial magnetic stimulation before.