Zupanc M L, Dobkin J A, Perlman S B
Department of Neurology, University of Wisconsin Hospitals, Madison 53792.
Pediatr Neurol. 1991 Jan-Feb;7(1):35-8. doi: 10.1016/0887-8994(91)90103-r.
Alternating hemiplegia of childhood is an unusual disorder characterized by early onset (occurring before 18 months of age); repeated attacks of hemiplegia involving both sides of the body; other paroxysmal phenomena, such as tonic stiffening, dystonic posturing, choreoathetoid movements, ocular motor abnormalities, and autonomic disturbances, in association with bouts of hemiplegia or occurring independently; and evidence of mental or neurologic deficits. A girl was examined because of left hemiplegia at the age of 16 months. The patient had begun exhibiting episodes of alternating hemiplegia at approximately 4 months of age. They consisted of tonic stiffening and dystonia of the right or left extremities, lasting from 30 min to several hours and followed by residual hemiparesis. They were invariably accompanied by ocular motor abnormalities. Magnetic resonance imaging, computed tomography, and angiography all were normal. Single proton emission computed tomography brain images during an acute episode of right hemiplegia demonstrated hypoperfusion of the left cerebral hemisphere. Following improvement of the hemiplegia, the patient was re-evaluated. The uptake of the radiotracer in the left hemisphere was increased. The scan did not demonstrate significant asymmetry in cerebral perfusion.
儿童交替性偏瘫是一种罕见的疾病，其特征为起病早（18个月前发病）；身体两侧反复出现偏瘫发作；伴有偏瘫发作或独立出现的其他阵发性现象，如强直性僵硬、张力障碍姿势、舞蹈手足徐动症样运动、眼球运动异常和自主神经功能紊乱；以及存在精神或神经功能缺陷。一名16个月大的女孩因左侧偏瘫接受检查。该患者约在4个月大时开始出现交替性偏瘫发作。发作表现为右或左上肢和下肢的强直性僵硬和肌张力障碍，持续30分钟至数小时，随后遗留偏瘫。发作总是伴有眼球运动异常。磁共振成像、计算机断层扫描和血管造影均正常。在右侧偏瘫急性发作期间的单光子发射计算机断层扫描脑图像显示左侧大脑半球灌注不足。偏瘫改善后，对患者进行了重新评估。放射性示踪剂在左侧半球的摄取增加。扫描未显示脑灌注有明显不对称。
