Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

April 09, 2019; 92 (15 Supplement) May 7, 2019

Autonomic Related Gastrointestinal Manifestations of Alternating Hemiplegia of Childhood (P3.6-063)

Milton Pratt, Lyndsey Prange, Melissa McLean, Mohamad Mikati
First published April 16, 2019,
Milton Pratt
1Duke University Medical Center Durham NC United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lyndsey Prange
1Duke University Medical Center Durham NC United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Melissa McLean
1Duke University Medical Center Durham NC United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mohamad Mikati
1Duke University Medical Center Durham NC United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Citation
Autonomic Related Gastrointestinal Manifestations of Alternating Hemiplegia of Childhood (P3.6-063)
Milton Pratt, Lyndsey Prange, Melissa McLean, Mohamad Mikati
Neurology Apr 2019, 92 (15 Supplement) P3.6-063;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
0

Share

  • Article
  • Info & Disclosures
Loading

Abstract

Objective: Describe and analyze autonomic dysfunction related gastrointestinal manifestations in Alternating Hemiplegia of Childhood (AHC).

Background: Many disorders of the central and autonomic nervous system lead to gastrointestinal symptoms. AHC manifests as recurrent episodes of paralysis, dystonia and autonomic dysfunction. However, gastrointestinal symptoms have not previously been recognized to be a significant problem in AHC.

Design/Methods: We studied a cohort of 15 sequential AHC patients seen during a 6 month period in our AHC clinic and analyzed the data entered in our IRB-approved AHC database. Gastrointestinal symptom severity was scored (no symptoms=1, reported symptoms but no intervention needed=2, medication intervention=3, surgical intervention=4) then correlated with previously established and published measures of AHC CNS disease severity scores: paroxysmal index scores, non-paroxysmal index scores, severity of intellectual disability scores, and Gross Motor Function Classification System (GMFCS) scores.

Results: All 15 patients exhibited gastrointestinal symptoms related to autonomic dysfunction that warranted medical attention. These included: vomiting (10), constipation (10), anorexia resulting in weight loss/failure to thrive(9), dysphagia (9), diarrhea (5), aspiration (4), nausea (4), abdominal distension (3), sialorrhea (3), and abdominal pain (2). Specific diagnoses included GERD (9), swallowing difficulty (9), and gastroparesis (2). Medication management was needed in 13 patients. Surgical interventions included gastrostomy tubes in 7 (due to poor PO intake in 5/7 and recurrent aspirations in 2/7) and Nissen Fundoplication due to GERD (2/7). Additionally, botulinum toxin injections to the pylorus due to gastroparesis (1) and botulinum toxin injections to salivary glands due to excessive sialorrhea (1) were performed. Correlations between gastrointestinal symptom severity and non-paroxysmal index scores, severity of intellectual disability scores, and GMFCS scores were: r=.419, .279, and .347, respectively.

Conclusions: Gastrointestinal problems are common, are occasionally severe, and correlate with disease severity in patients with AHC. Awareness of these problems and anticipatory guidance should help in planning appropriate medical and surgical interventions.

Disclosure: Dr. Pratt has nothing to disclose. Dr. Prange has nothing to disclose. Dr. McLean has nothing to disclose. Dr. Mikati has nothing to disclose.

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
  • Info & Disclosures
Advertisement

Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study

Dr. Robert Shapiro and Dr. Amynah Pradhan

► Watch

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: 100 (5)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise