Alternating hemiplegia of childhood: case report

Area of Science:

• Neurology
• Vascular Neurology

Background:

• Alternating hemiplegia is a rare neurological disorder characterized by recurrent, transient episodes of hemiplegia.
• The exact etiology remains unclear in many cases, with genetic and environmental factors being investigated.

Observation:

• A 3 1/2-year-old girl presented with alternating hemiplegia attacks starting at 6 months of age.
• Key features included mild vertebral artery stenosis, attacks triggered by upright posture, and possible atmospheric pressure influence.
• The patient experienced no significant relief with phenobarbital, haloperidol, or nadolol.

Findings:

• Flunarizine demonstrated some therapeutic effect in managing the alternating hemiplegia attacks.
• The case suggests a potential link between vertebral artery stenosis and the hemiplegic episodes.
• Postural changes and atmospheric variations were noted as potential triggers.

Implications:

• This case expands the understanding of potential etiopathogenetic factors in alternating hemiplegia.
• It highlights flunarizine as a potential treatment option for similar cases.
• Further research into vascular and environmental influences on alternating hemiplegia is warranted.