title: [Alternating hemiplegia of childhood in Spanish population. Study of a series of 17 patients].
abstract: OBJECTIVE
  Alternating hemiplegia of childhood (AHC) is a rare disease of unknown etiology characterized by early onset of recurrent episodes of hemiplegia, tonic or dystonic attacks and abnormal ocular movements with a fatal outcome to severe encephalopathy. Our aim was to describe the clinical manifestations, precipitating factors, complementary studies results, long-term outcome and response to treatment in a series of AHC patients.
  
  
  METHODS
  Descriptive, retrospective and multicenter study in 17 Spanish patients aged between 1-24 years who fulfilled diagnostic criteria of AHC.
  
  
  RESULTS
  Twelve cases fulfilled criteria of typical AHC and 5 were atypical. Mean age at diagnosis was 26 months and 47% cases had a family history of migraine. Mean age at onset of hemiplegic attacks was 9.3 months. Symptoms disappeared during sleep and precipitating factors were present in 94% cases. Most patients developed mental retardation with ataxia and dysarthria. Work-up tests (metabolic, neurophysiologic and radiologic) were normal or nonspecific. In 3 patients mutations in CACNA1A, ATP1A2 were ruled out. Positive responses to flunarizine was observed in 81%.
  
  
  CONCLUSIONS
  The characteristic clinical symptoms are still the clue to make the diagnosis of this disease, with a lack of genetic, biochemical or radiological specific studies. Early diagnosis avoids invasive tests, repeating procedures, using ineffective and potentially toxic treatments, and allows to start treatment with flunarizine without delay. More genetic studies are needed in broader series of patients.
authors.affiliation: Servicio de Neurología, Hospital Universitario Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. cfons@hsjdbcn.org
authors.forename: Carmen
authors.initials: C
authors.lastname: Fons
authors.forename: Jaume
authors.initials: J
authors.lastname: Campistol
authors.forename: Juan
authors.initials: J
authors.lastname: Narbona
authors.forename: Ramón
authors.initials: R
authors.lastname: Velázquez
authors.forename: Jesús
authors.initials: J
authors.lastname: Eiris
authors.forename: Juan José
authors.initials: JJ
authors.lastname: García Peñas
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006429:Hemiplegia / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D013030:Spain