A rare neurological condition called alternating hemiplegia typically strikes children before they become 18 months old. Recurrent paralysis episodes that affect one or both sides of the body, many limbs, or a single limb are the disorder's defining feature. Various body parts may experience paralysis at different periods, and it may last for a few hours to several days. After falling asleep, these episodes frequently end. 

Along with walking and balance issues, children who are affected may also have abnormal motions involving stiffening or "dance-like" movements of a limb. Some kids experience seizures. Children's development might be normal or delayed. 

The condition comes in both mild and dangerous forms. The disorder does not run in families for the majority of kids, but new research has revealed that certain kids with a family history have mutations in the genes CACNA1A, SCN1A, and ATP1A2. Families affected by familial hemiplegic migraine have previously been linked to mutations in the ATP1A2 gene.

Symptoms:

Hemiplegia symptoms vary from person to person and depend on how severe the illness is. 

Hemiplegia signs and symptoms include:

• Reduced motor functions
• Having trouble gripping onto or grabbing onto things
• Muscles on one side of the body are weak or stiff.
• Spasticity of the muscles or permanently constricted muscles
• Bad balance
• Having trouble walking

Additionally, a traumatic brain injury might cause symptoms that are specific to the brain damage itself. These might include signs like:

• Behavioural changes
• Speech issues
• Trouble focusing, remembering, paying attention, or thinking
• Anxiousness, agitation, and confusion

Children with hemiplegia may exhibit symptoms like:

• Move more slowly
• Walking on their toes
• Keeping one hand fisted 
• Children before the age of 12 prefer one hand over the other.

Types:

Hemiplegia and hemiparesis both refer to weakness on one side of the body and are brought on by the same diseases and traumas. Hemiplegia often refers to total paralysis, whereas hemiparesis generally refers to partial weakening.

• Hemiplegia is a symptom that results in paralysis on one side of your body, either the left or the right. Hemiplegia is a major stroke symptom, therefore it nearly always warrants seeking emergency medical attention (unless you have a recognised medical condition that causes hemiplegia, in which case your doctor may advise against it).
• Hemiparesis is a condition that causes weakness on one side of the body. Patients suffering from hemiparesis may experience challenges while moving their arms or tingling or other unusual sensations on one side of their body.

Stroke, the most typical cause of hemiplegia, and hemiparesis are usually treatable with prompt medical attention. It's crucial to get medical attention as soon as possible for this disorder to be curable or reversible.

Diagnosis:

AHC can be diagnosed using specific symptoms, a complete clinical assessment, a full patient history, and a range of specialist testing.

AHC is generally diagnosed by exclusion. To rule out other conditions, a wide range of specialist tests may be applied. These examinations consist of magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and magnetic resonance spectroscopy (MRS). An MRI creates cross-sectional pictures of specific organs and biological tissues, such as brain tissue, by using a magnetic field and radio waves. To assess the blood vessels, an MRA is created. Metabolic alterations in the brain and other organs are discovered using an MRS.

The electroencephalogram (EEG), which measures brain electrical activity and is typically used to diagnose epilepsy; the cerebrospinal fluid (CSF) study, which can rule out neurotransmitter deficiency disorders with similar episodic oculomotor abnormalities; the erythrocyte sedimentation rate, which measures how long it takes red blood cells to settle; and the metabolic screening to detect urine organic acids, which is indicative of certain metabolic disorders, are additional tests that may be performed.

Clinical molecular genetic testing for ATP1A3 gene mutations is available as part of broader gene panels or as an individual-focused gene sequencing test. In the context of clinical exome sequencing, ATP1A3 mutations are being discovered more often.

Alarming factors:

Alternating hemiplegia is a rare neurological disorder that can be alarming due to the sudden onset of symptoms, severe motor impairments, cognitive and developmental delays, and a high mortality rate. Early diagnosis and management of symptoms are critical, and treatment may include medications and therapies to manage symptoms and support motor function and cognitive development.

Conclusion:

Hemiplegia is a major sign of stroke, a potentially fatal medical emergency. As a result, you should avoid attempting to self-diagnose or self-treat it. One exception to this rule is if you have permanent hemiplegia due to another non-life-threatening ailment or if you experience temporary hemiplegia due to a condition like migraines. In each of these scenarios, discuss your condition and symptoms with your healthcare provider. They can advise you on the occasions when hemiplegia needs emergency medical intervention.