Key result
Flunarizine is linked to shorter childhood hemiplegic attacks but completely halts episodes in only ~11%.
Why the study?
Alternating hemiplegia of childhood is a rare syndrome with unknown mechanism and uncertain long-term treatment effects of flunarizine.
Does flunarizine reduce the duration or frequency of attacks in patients with alternating hemiplegia of childhood?
Observational (n=10)
Does flunarizine reduce the duration or frequency of attacks in patients with alternating hemiplegia of childhood?
Flunarizine may reduce the duration of attacks in alternating hemiplegia of childhood, but it rarely leads to complete cessation of episodes and its effect on long-term cognitive and motor deficits remains uncertain.
May shorten attacks without remission in alternating hemiplegia of childhood; leaves open efficacy and long-term effects pending controlled trials.
Alternating hemiplegia of childhood is a rare syndrome characterized by onset before 18 months of age of frequent attacks of alternating paralysis, transient ocular palsies, nystagmus, choreoathetosis, and autonomic dysfunction. We describe features of 10 patients followed for up to 27 years. The mechanism of alternating hemiplegia remains unknown but an association to migraine is suspected because of the strong family history of migraine and aura symptoms in some patients. We treated nine patients with flunarizine, a calcium channel blocker, for up to 5 years; they showed a reduction in duration of the hemiplegic attacks, but the episodes ceased completely in only one patient. With long-term follow-up, the persistent motor, movement, and cognitive deficits are more apparent. It is not certain if the flunarizine alters this course.
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Silver et al. (1993) conducted an observational in Alternating hemiplegia of childhood (n=10). Flunarizine was evaluated on Reduction in duration or cessation of hemiplegic attacks. Flunarizine reduced the duration of hemiplegic attacks in patients with alternating hemiplegia of childhood, but episodes ceased completely in only 1 of 9 treated patients.
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