[A boy with nystagmus, refractory dystonia and apneic attack due to alternating hemiplegia of childhood].
We herein report the findings of a 2-year-6-month-old boy, who had been experiencing monocular pendular nystagmus, strabismus, and episodic eye deviation nystagmus, intractable dystonia and apneic attack which all began when he was 2 days of age. He underwent a complete blood count test, blood chemistry test, analysis of amino acids in the blood and urine, analysis of pyruvate/lactate in blood and cerebrospinal fluid, head computed tomography and magnetic resonance imaging and no abnormal results were identified. His attacks were resistant to multiple antiepileptic and dopaminergic drugs. He showed transient left and/or right hemiplegia after nystagmus, dystonia and/or apneic attacks at 8-months of age with retardation in intelligence. We diagnosed him to have alternating hemiplegia of childhood (AHC). We were unsure how to deal with his attacks after he was discharged from the hospital, however, resuscitation with the ambu bag by his mother at home and the intravenous infusion of diazepam or thiamylal at the hospital together was proven to be an effective method for treating his severe apneic attacks. The effect of diazepam and amantadine on these attacks was transient, however, the administration of flunarizine with amantadine resulted in an improvement in his attacks. We therefore consider the administration of flunarizine to be essential for the effective treatment of AHC in this case.
Shiota
Naoki
N
Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka. n-shiota@med.uoeh-u.ac.jp
Shimono
Masayuki
M
Tomioka
Shiho
S
Takano
Kenichi
K
Kato
Ayako
A
Kawakami
Akihiro
A
Ishizuka
Takehiro
T
D000547:Amantadine / Q000008:administration & dosage; D000927:Anticonvulsants / Q000627:therapeutic use*; D001049:Apnea / Q000209:etiology* / Q000628:therapy; D002675:Child, Preschool; D004421:Dystonia / Q000188:drug therapy / Q000209:etiology*; D005444:Flunarizine / Q000627:therapeutic use*; D006429:Hemiplegia / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009759:Nystagmus, Pathologic / Q000209:etiology*; D012121:Respiration, Artificial
D000927:Anticonvulsants; D000547:Amantadine; D005444:Flunarizine