Benign nocturnal alternating hemiplegia of childhood: a new case with unusual findings

It has been described a neuro developmental disorder labelled “Benign nocturnal alternating hemiplegia of childhood” (BNAHC)characterized by recurrent attacks of nocturnal hemiplegia without progression to neurological or intellectual impairment. Wereport a female patient who at 11 months revealed a motionless left arm, unusual crying without impairment of consciousnessand obvious precipitating factors. The attacks occur during sleep in the early morning with lack of ictal and interictal electroencephalographicabnormalities, progressive neurological deficit, and cognitive impairment. Unlike previous reports of BNAHC ourpatient come from a family with a history of both migraine, hemiplegic migraine, and sleep disorders. Our study remarks on thetypical features described in previous studies and stresses the uncommon aspects that could help to identify the disorder which islikely to have been underestimated. Despite some clinical similarities between BNAHC and familiar hemiplegic migraine and alternatinghemiplegia of childhood, the genetic analyses of our patient did not reveal genetic mutations found in both disorders.