Due to these diagnostic difficulties, it is possible that the commonness of the disease is underestimated.The following descriptions are commonly used in the diagnosis of AHC. The initial four criteria for classifying AHC were that it begins before 18 months of age, includes attacks of both hemiplegia on either side of the body, as well as other autonomic problems such as involuntary eye movement (episodic monocular nystagmus), improper eye alignment, choreoathetosis, and sustained muscle contractions (dystonia). Finally, patients suffer from intellectual disabilities, delayed development, and other neurological abnormalities. These diagnostic criteria were updated in 1993 to include the fact that all of these symptoms dissipate immediately upon sleeping. Diagnostic criteria were also expanded to include episodes of bilateral hemiplegia which shifted from one side of the body to the other.Recent criteria have been proposed for screening for AHC early, in order to improve the diagnostic timeline. These screening criteria include focal or unilateral paroxysmal dystonia in the first 6 months of life, as well as the possibility of flaccid hemiplegia either with or separate from these symptoms. Paroxysmal ocular movements should also be considered, and these should include both binocular and monocular symptoms which show in the first 3 months of life. Treatments
Overall outcomes for AHC are generally poor, which is contributed to by AHCs various diagnostic and management challenges. In the long term, AHC is debilitating due to both the hemiplegic attacks and permanent damage associated with AHC. This damage can include cognitive impairment, behavioral and psychiatric disorders, and various motor impairments.
This indicates that iron alone is enough to cause damage to the lungs.Symptoms usually appear after a number of years, but may rarely appear within a year.Eye exposure to iron dust can also cause another form of siderosis, "ocular siderosis" or "siderosis bulbi", which can cause eye discoloration, but also eye damage, like cataracts and night blindness. This happens via the corrosive effects of iron. Cause
Pulmonary siderosis is caused by repeated inhalation of fine iron or rust dust that happens usually over a number of years. This can happen during work consisting of welding, grinding, foundry work, paint manufacture or iron ore mining among other similar occupations where a person is exposed to fine iron dust or fumes. Diagnosis
Pulmonary siderosis causes changes within the lungs that are clearly visible in tissue samples, x-ray images and other radiological studies. In a tissue sample from alveoli patchy deposits of iron can be seen throughout the sample. Treatment
There is no cure for pulmonary siderosis or other interstitial lung diseases. Any damage is thus permanent. Symptoms can be treated. Prognosis
Outcome of pulmonary siderosis is often good if the inhalation of iron or rust dust is permanently avoided. However, welding has been associated with lung cancer, a condition which may have a poor outcome. Still, it is not known if pulmonary siderosis causes cancer in welders specifically or if these cases of cancer appear due to entirely different factors.