<unk>  patients exhibit a wide range of symptoms in addition to<unk>  attacks. These can be further characterized as paroxysmal and non-paroxysmal symptoms. Paroxysmal symptoms are generally associated with<unk>  attacks and may occur suddenly with<unk>  or on their own. Paroxysmal symptoms may last for variable amounts of time. Non-paroxysmal symptoms tend to be side effects of<unk>  which are present at all times, not just during episodes or attacks. Epilepsy, which is also considered a paroxysmal symptom, plays an important role in the progression and diagnosis of<unk> .<unk>  attacks Chronologically,<unk>  attacks are not always the first symptom of<unk> , but they are the most prominent symptom, as well as the symptom for which the disorder is named.<unk>  attacks may affect one or both sides of the body, and attacks which affect both sides of the body may be referred to as either bilateral or quadriplegic attacks. One of the unique characteristics of<unk>  is that<unk>  attacks, as well as other symptoms which may co-occur with<unk> , cease immediately upon sleep. During strong attacks, the symptoms may reoccur upon waking.<unk>  attacks can occur suddenly or gradually, and the severity of an attack can vary over its duration. The attacks may alternate from one side of the body to another, though this is rare. The length of attacks may also vary from minutes to weeks, though length of attacks varies more greatly between people than between attacks for one person. Both bilateral and<unk>  attacks are associated with pseudobulbar features such as dysphagia, dysarthria, and respiratory difficulty. Paralysis is also often accompanied by changes in skin color and temperature, sweating, restlessness, tremor, screaming, and the appearance of pain.<unk>  attacks happen irregularly and can occur with speech, eating, and swallowing impairment. Patients with<unk>  are frequently underweight due to these side effects. The average age of onset for<unk>  episodes has been found to be 6–7 months of age. This early onset gives the name of this disorder the slightly misleading ending "of<unk> ".<unk>  is not exclusively limited to<unk>  – attacks in some cases become milder after the first ten years of life, but they never completely disappear. Paroxysmal symptoms<unk>  patients have exhibited various paroxysmal symptoms which manifest to different degrees in each person. Paroxysmal symptoms include tonic, tonic-clonic, or myoclonic limb movements, dystonic posturing, choreoathetosis, ocular nystagmus, and various other ocular motor abnormalities. Almost half of all people have dystonic symptoms prior to experiencing<unk> . These symptoms generally begin before 8 months of age. Ocular motor abnormalities occur early, and these are the most frequent early symptoms of<unk> , particularly nystagmus. Almost 1/3 of people with this disorder had episodic ocular motor features within 1–2 days of birth. Many also experienced<unk>  and dystonia before 3 months of age. A final symptom that may be considered paroxysmal is a temporary change in behavior - some patients will become unreasonable, demanding, and aggressive either before or after an attack Not all patients have all of these symptoms, and it is not known whether they are caused by<unk> . Symptoms usually manifest in the first 3 months of the child's life, with an average onset of 2.5 months. Frequently, some of these symptoms will manifest in the neonatal period. These paroxysmal symptoms are often used to help diagnose<unk> , since there is no simple test for it. In some cases, EEGs taken during these paroxysmal events were characterized by a generalized background slowing. Overall however, EEG during episodes and other investigative methods such as brain MRI, TACs, angiographic MRIs and CFS have normal results. Non-paroxysmal symptoms In the long term, many paroxysmal symptoms occur along with<unk> , and while these symptoms vary in strength depending on the person, they are consistent features of<unk> . It is thought that some of these symptoms are brought on or worsened by<unk>  attacks, though it is not known for certain. Patients suffer persistent motor, movement (ataxia), and cognitive deficits. These deficits become more apparent over time and include developmental delays, social problems, and retardation. It is rare for someone with<unk>  not to have cognitive deficits, but a study in Japan did find two patients who met all of the diagnostic criteria for<unk>  but who were not mentally impaired. It is not known whether<unk>  is a progressive disease, but severe attacks are suspected to cause damage which result in permanent loss of function. 100% of children studied in the USA have had some form of mental impairment, which is usually described as mild to moderate, but varies greatly among individuals. Epilepsy At least 50% of<unk>  sufferers also suffer from epilepsy, and<unk>  is often misdiagnosed as epilepsy because of this. These epileptic events are distinguished from other episodes by an alteration of consciousness, as well as frequent tonic or tonic-clonic activity. Epileptic episodes are generally rare, though they do increase with age. Due to the rarity of epileptic episodes, there are few EEG confirmations of them.
Alternating hemiplegia of childhood
Chronic paroxysmal hemicrania
Acute cerebellar ataxia of childhood
Ataxic cerebral palsy
Dyskinetic cerebral palsy
Babinski–Nageotte syndrome
Non-progressive congenital ataxia
Infantile progressive bulbar palsy