Cerebellar RTMS in Patients with Multiple Sclerosis

Inclusion Criteria: * 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. Exclusion Criteria: * Any other neurological deficits or orthopedics abnormalities. * Ataxic manifestations for other cause rather than Multiple Sclerosis. * Other neurological manifestations (e.g. spasticity, visual loss) * Secondary musculoskeletal complication such as contractures or deformities. Cardiovascular, pulmonary, hepatic, renal, hemopoietic and thyroid diseases. * Pregnant women. * Addicted individuals. * Previous surgeries in the brain. * Any magnetic or metallic devices implanted (like cochlear implants) . * Psychotic deficits or history of epileptic seizures.