儿童交替性偏瘫1例报道

Alternating Hemiplegia of Children: A Case Report

摘要: 目的：探讨儿童交替性偏瘫(Alternating hemiplegia of childhood, AHC)的临床特点和诊疗对策。方法：对我院收治的1例AHC患儿的临床资料进行回顾性分析。结果：本例患儿呈反复发作，时间间隔不定的交替性偏瘫，伴进行性认知功能减退斜视及眼球震颤，经氟桂利嗪治疗3月后，症状无明显改善，则添加托吡酯联合治疗，随访8个月后未再发作。结论：AHC临床中少见，临床症状较复杂，应注意鉴别，目前以氟桂利嗪为首选药物，但对于应用氟桂利嗪疗效欠佳或无效者，可添加托吡酯治疗。

Abstract: Objective: To explore the clinical features, diagnosis and treatment of alternating hemiplegia of childhood (AHC). Methods: The clinical data of one case with AHC admitted to our hospital was retrospectively analyzed. Results: The child was characterized by repeated episodes of hemiplegia in alternate sides or both sides of the body, with other paroxysmal clinical signs, including dystonic posture, choreoathetoid movements and nystagmus. The symptoms didn’t improve much when he was treated only with flunarizine for 3 months. Then he was added with topiramate and the frequency and the duration of the hemiplegic attacks dramatically reduced. A follow-up of 8 months, the attacks didn’t occur any more. Conclusion: AHC is rare and the syndrome is complex. It should be differentially diagnosed. Flunarizine is the first-line drug of AHC. But when flunarizine fails, the combination of flunarizine and topiramate may be more effective.