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Alternating hemiplegia in infants: report of five cases
Insights
Alternating hemiplegia in infancy is a distinct neurological syndrome characterized by recurrent, temporary paralysis on alternating sides of the body. Early recognition is crucial for managing this rare condition and its associated symptoms.
Area of Science:
- Neurology
- Pediatrics
Background:
- Alternating hemiplegia in infancy (AHI) is a rare, severe early-onset epilepsy syndrome.
- Distinguishing AHI from other hemiplegic conditions is critical for accurate diagnosis and management.
Observation:
- This study reports five new cases of AHI, detailing associated ictal manifestations.
- Observed symptoms included tonic seizures, dystonic posturing, nystagmus, and autonomic disturbances.
Findings:
- Fourteen previously reported cases were critically reviewed and deemed consistent with AHI.
- AHI presents as a recognizable syndrome with distinct clinical features differentiating it from common hemiplegia or basilar migraine.
Implications:
- AHI represents a well-defined neurological disorder with a guarded prognosis for mental and neurological development.
- Further research into the nosology and underlying mechanisms of AHI is warranted.
Abstract:
Five cases of alternating hemiplegia in infancy are reported. Special consideration is given to the associated ictal manifestations (tonic seizures, dystonic posturing and abnormal movements bouts of nystagmus and acute autonomic disturbances), some of which were noted in every case. Previously reported cases are reviewed critically, 14 of whom are considered to belong to the same syndrome as the five presented here. The nosology of the syndrome is discussed, and the differences between alternating hemiplegia and the common types of hemiplegia or basilar migraine are emphasized. Whatever its exact nature, alternating hemiplegia in infancy constitutes a well-defined and recognizable syndrome, with a guarded mental and neurological prognosis.