The Role of Repetitive Transcranial Magnetic Stimulation in Spastic Hemiplegic Cerebral Palsy in a Sample of Egyptian Children

Abstract

Background: One of the most common neurologic disorders is cerebral palsy. To improve quality of life, many tools have been employed. rTMS is a new established technique to treat spasticity and improve the outcome of rehabilitation program in various neurologic conditions. Aim of The Work: To assess the effect of high frequency rTMS on improving spasticity and motor performance in spastic hemiplegic CP in a sample of Egyptian children. Patients and Methods: 65 children aged between 4-18 years attending the Neuro-Pediatric Unit of Al-Azhar University hospitals were recruited in the period from beginning of Jan, 2022 to the end of June, 2022. They were randomly allocated into two groups : Study Group: 40 patients received 8 sessions of high frequency rTMS (2 sessions per week for 4 weeks) followed by physical therapy (PT) of 30 minutes duration. 1500 pulses (50 pulses per train with total 30 trains) per session with an intensity of 90% of the motor threshold at a frequency of 10 Hz were received. Contralateral primary motor cortex (M1) was the site of stimulation. Each train had duration of 30 sec with inter-train delay of 25 seconds. Control Group: 25 patients received only physical therapy (PT) of 30 minutes (2 sessions per week for 4 weeks). Results:The study group has been improved statistically significantly as compared with the control group. Conclusion: r-TMS essentially contributes to reducing spasticity and enhancing motor performance in hemiparetic CP children.