Rapid magnetic stimulation with sonolysis for gait apraxia due to normal pressure hydrocephalus and cerebral ischemia

Results of shunting or other treatment for gait apraxia associated with normal pressure hydrocephalus and periventricular ischemia are still dubious and the condition is progressive. We treated 15 consecutive cases by a two pronged approach using rapid magnetic stimulation (RMS) and sonolysis. Patients selected presented primarily with gait apraxia. All were evaluated by full clinical and blood examination, MRI, MRA and ultrasound of the neck and cerebral vessels. Rapid magnetic stimulation was administered daily for seven days and sonolysis or therapeutic ultrasound for three days. Patients were reviewed for three months and therapy repeated. The Barthel's index was used for evaluation. The data before treatment was compared with that after six months and there was overall statistically significant improvement. Shunt therapy could be avoided and two post shunt failures responded to this regime.