Alternating Hemiplegia of Childhood (AHC) is an exceptionally rare and intricate neurodevelopmental condition, characterized by recurrent episodes of hemiplegia that switch sides of the body. The disorder is accompanied by a variety of neurological symptoms, including involuntary muscle contractions, atypical eye movements, developmental delays, seizures, and autonomic irregularities. These complexities present significant challenges in diagnosis and management, with mutations in the ATP1A2 and ATP1A3 genes identified as key contributors to the disorder's underlying mechanisms. This case series offers a retrospective analysis of 4 patients with genetically confirmed AHC. Data was meticulously gathered from medical records, neurological evaluations, neuroimaging, genetic analyses, and interviews with patients and their caregivers. The cases illustrate the heterogeneity in AHC's clinical manifestations, from developmental delays to pronounced seizure activity. Tailored treatment plans, including the administration of flunarizine and various anti-epileptic drugs, were crafted to meet individual patient needs, resulting in differing levels of symptom control and developmental progress. This case series emphasizes the importance of genetic testing for early and accurate diagnosis of AHC. Although managing this chronic condition remains challenging, insights into the genetic basis of AHC can inform targeted therapeutic strategies. Through this series, we aim to deepen the understanding of AHC, promote prompt diagnosis, and ultimately improve the quality of life for affected individuals and their families.

Amarjeet Wagh is the first pediatric and developmental neurologist. He is also the pioneer of establishing an exclusive epilepsy treatment cell in Central India. He has vast experience of more than 15 years in the field of pediatric neurology. He is trained in pediatric Neurology from an esteemed university in India named Amrita Institute of Medical Sciences, Cochin. He is also affiliated with the British Pediatric Neurology Association (BPNA), UK, and NIMHANS, Bangalore. He is an expert in the treatment of children having epilepsy, metabolic disorders, autism, ADHD, headache, childhood paralysis, cerebral palsy, learning disability, speech delay, and all other child neurology and brain developmental problems. He has a keen interest in treating children with epilepsy, autism, neurogenetic disorders, and learning disabilities.