Case Report | DOI: https://doi.org/10.31579/2690-4861/1096
1Diploma in medical emergencies and urgent care, Head of the Department of Clinical Neurophysiology, Central Havana Teaching Pediatric Hospital, Cuba.
2Comprehensive General Medicine and Clinical Genetics, Master in genetic counseling.
*Corresponding Author: Ernesto Portuondo Barbarrosa, Diploma in medical emergencies and urgent care, Head of the Department of Clinical Neurophysiology, Central Havana Teaching Pediatric Hospital, Cuba.
Citation: Ernesto P. Barbarrosa, Gretel H. Pérez, (2026), Alternating Hemiplegia of Childhood in a Clinical Context Case Presentation, International Journal of Clinical Case Reports and Reviews, 36(2); DOI:10.31579/2690-4861/1096
Copyright: © 2026, Ernesto Portuondo Barbarrosa. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Received: 07 April 2026 | Accepted: 25 May 2026 | Published: 01 June 2026
Keywords: alternating hemiplegia of childhood; flunarizine
Introduction: Alternating hemiplegia of childhood (AHC) is a rare disease characterized by recurrent episodes of alternating hemiplegia or quadriplegia that improve during sleep and vary in duration. Onset occurs before 18 months of age and is preceded by abnormal eye movements, accompanied by tonic and dystonic attacks with subsequent developmental regression. The main etiology is related to the ATP1A3 genetic mutation.
Clinical case: A 16-month-old male preschooler with no significant personal or family history. He had previously experienced psychomotor developmental delay in motor skills and language, accompanied by abnormal eye movements. At 12 months of age, he had two episodes: the first, in the context of an arboviral infection, resulted in diplegia; the second, following a prolonged bus trip, involved left hemiplegia lasting 7 days, with spontaneous recovery and no alteration of consciousness, followed by dystonic episodes. Complementary studies of cerebrospinal fluid cytochemistry and culture, multislice cranial CT scan, and normal metabolic studies in urine and serum were performed. Electroencephalography showed slow delta global activity without paroxysms. Treatment was initiated with flunarizine 5 mg daily at night. Follow-up was in the Neuropediatrics outpatient clinic. Genetic testing was limited.
Conclusion: Alternating hemiplegia of childhood (AHC) is an entity whose diagnosis is essentially clinical, and our patient met the clinical criteria. Treatment with flunarizine is important to improve prognosis and quality of life.
Alternating hemiplegia of childhood (AHC) is a rare and uncommon disease. Its incidence is estimated at approximately 1 per 1,000,000 live births, but this number may be underestimated due to the variability of symptoms and clinical signs in different epidemiological studies. 1-5 It was first described by Verret and Stele in 1971 as alternating hemiplegic migraine. 6 In 1980, Krakelog and Aircardi differentiated AHC from other hemiplegias in their publication and established diagnostic criteria that are still valid today, because the paroxysmal and non-paroxysmal symptoms, in conjunction with psychomotor developmental regression (PMD) and cognitive impairment, allowed its exclusion from that hypothesis. 7
The pathophysiological mechanisms of autoimmune hepatitis (AIH) remain unknown and enigmatic. Its genetic etiology, in combination with environmental factors, has recently been clarified. It has been identified as being related to the ATP1A3 gene (previously associated with parkinsonism-dystonia of sudden onset). This gene is located on chromosome 19q13.2 in more than 70% of patients and has an autosomal dominant inheritance pattern, although de novo cases are more common. There are more than 60 phenotypic variants of the disease, the most frequent being D801N (43%), E815K (16%), L839P and G947R (11%), and other variants involving the ATP1A2 gene (1q23.3), CACNA1A, and SLC1A3. It is considered a channelopathy with inhibited activity of the Na + /K + ATPase pump, a subunit that encodes and is expressed exclusively in neurons and cardiac muscle cells; this justifies a favorable clinical response to flunarizine, a non-selective blocker of voltage-gated sodium and calcium channels. [1,3,6,8]
Clinically, it is characterized by a sequence of successive episodes of hemiplegia that alternately affect one side of the body, and less frequently quadriplegia or diplegia, which generally begin before 18 months of age, are of variable duration (from minutes, hours, days, or an undefined period), disappear during sleep, and return during wakefulness. These episodes are unaffected by any alteration of consciousness and are accompanied by other earlier-appearing clinical manifestations such as abnormal eye movements (paroxysmal nystagmus, upward eye deviation, and eye rolling), autonomic symptoms, tonic, dystonic, and choreoatetoxic attacks that can be confused with epileptic seizures, and in some patients, these seizures may appear later. [1-3, 6,9]
The diagnosis of AIH is essentially clinical and relies on diagnostic criteria, but demonstrating a genetic variant is of great value in confirming the diagnosis, estimating the prognosis, and providing genetic counseling. 1,6
The aim of our article is to present a clinical case of onset at 15 months of age with prior delayed puberty, without risk factors. The case meets the clinical criteria, but genetic confirmation cannot be demonstrated due to limitations in the studies.
A 16-month-old male preschooler, of Cuban nationality and from the province of Santiago de Cuba, rural area. Son of young, non-consanguineous parents, firstborn with no significant personal, prenatal, perinatal and postnatal medical history, with a gestational age of 39.2 weeks, vaginal delivery with APGAR (9/9), Weight/ 3000 gr, height/49cm and head circumference/ 34 cm and a hospital stay of 3 days with no significant family medical history.
Previous developmental delay: In the motor domain, head control at 5 months, rolling and sitting with support at 7 months, did not crawl and achieved standing with support at 12 months, and has attempted to take steps with support for 13 months. In the fine motor domain, the pincer grasp has not yet been acquired, and the child transfers objects from one hand to the other. Regarding language and hearing, the child communicated with cooing until 12 months and a few monosyllables, with otoacoustic emissions at birth and normal auditory evoked potentials. Socially, the child smiles, recognizes mother and family members, and blows kisses. Before 12 months, there were brief, sporadic episodes of upward gaze deviation, with variable frequency, without clinical evaluation.
History prior to 12 months in the context of an Arbovirus epidemic (dengue and chikungunya) in his province, admission with acute febrile syndrome of 5 days of evolution with maculopapular rash on the 3rd day of fever and restlessness and in clinical context "weakness of the lower limbs with immobility" and interpreted as a motor deficit without specifying the cause of duration of 7 days with spontaneous recovery.
At 15 months of age, during a 16-hour bus trip from Santiago de Cuba to Havana to visit relatives, upon arrival home, the child experienced weakness in the left side of the body and instability while standing. This was not related to fever or other infectious symptoms, and there was no evidence of contact with medications or other toxic substances, trauma, or altered mental status. The child was admitted to the Central Havana Teaching Pediatric Hospital through the emergency department and placed in the progressive care unit.
On physical examination and medical evaluation: the child was awake, interacted with the environment, and defended himself during the examination, with no evidence of altered mental status. During the examination of eye movements, mild, fatigable horizontal nystagmus was noted, with no cranial nerve palsies. Left hemiplegia was present with diminished deep tendon reflexes; no clonus or Babinski sign was observed. When seated with support, the child fell to the left side.
Additional tests:
Hematocrit / 0.34 ≈ 11.2 g/L of Hemoglobin, leukogram with leukocytes/7.2, polymorphonuclear cells 0.52, lymphocytes 0.48, normal coagulation panel with platelet count/ 330. Ionogram/blood gas analysis - normal with anion gap (18), transaminases glutamic-oxaloacetic (25 U/L), glutamic-pyruvic (28 U/L), lactate dehydrogenase (222 U/L) within normal parameters. Cerebrospinal fluid (CSF) with clear and transparent appearance, cells 0 x mm3, CSF glucose/ 3 mmol/L with blood glucose 4 mmol/L, proteins / 0.25 g/L within normal parameters with Gram stain and CSF culture without bacterial growth.
Urine metabolic tests (UMT) were performed, with amino acid and organic acid profiles using tandem spectrometry, with normal results. Multislice computed tomography (CT) showed no evidence of structural abnormalities (Figure 1a and 1b); the first electroencephalogram (EEG) during wakefulness and sleep showed slow delta activity (4-4.5 Hz), Figure 2a and 2b. Echocardiogram showed no structural or cardiac function abnormalities.
1a 1b
Figure 1a and 1b: Multislice CT scan, axial sequence with no evidence of structural abnormalities and normal ventricular system.
Figure 2a
Figure 2b
Figure 2a and 2b: 20-channel EEG, 10-20 system, spontaneous sleep, stage 1-2, with global slow delta activity (4-4.5Hz).
During his clinical evolution with a hospital stay of 15 days, he had spontaneous recovery of symptoms in 7 days and it was subsequently noted that he had brief waking events with opisthotonus posture, with video affiliation provided by the family and without alteration of consciousness; with a 2nd EEG of the same characteristics and without paroxysmal activity and being interpreted as dystonic events.
Based on the clinical presentation and patient history, with normal complementary studies allowing for differential diagnosis with other conditions and meeting clinical criteria, a diagnosis of autoimmune hypertension (AIH) was determined in conjunction with the genetics service. Treatment was initiated with flunarizine 5 mg/24 hours at night. During outpatient follow-up over two months, there was only one episode affecting the right side of the body, lasting 48 hours, with no improvement in motor function. The patient communicated using jargon and monosyllables, stood with support, and took a few steps with support. The patient was integrated into a community program for motor function stimulation and rehabilitation.
AIH is a rare, uncommon, and low-incidence condition that is difficult for medical personnel to recognize and identify. In early childhood, these episodes are often confused with infant seizures, making epilepsy a differential diagnosis to consider. 1,3,10 Other differential diagnoses would include: Moyamoya angiopathy or other arteriovenous malformations, ischemic stroke, inborn errors of metabolism (organic acidurias, urea cycle disorders, and pyruvate dehydrogenase deficiency), mitochondrial encephalopathies (MELAS and Kearns-Sayre), hypokalemic periodic paralysis, early epileptic encephalopathy with infantile spasms (EEIS) vs. West syndrome, Todd's postictal paralysis, CAPOS syndrome (cerebellar ataxia, areflexia, optic atrophy, and pes cavus), RPD syndrome (rapid onset dystonia-parkinsonism) at a later age that share the same ATP1A3 gene , and familial hemiplegic migraine. [9,11-14]
The disease is characterized by clinical manifestations that can be organized into different stages or phases. [6-9]
Phase one (first months of life): abnormal eye movements (nystagmus, rolling, upward gaze deviation) with or without delay in DPM.
Phase two (1 to 5 years): episodes of alternating hemiplegia while awake, less frequently quadriplegia and diplegia without altered consciousness, of variable duration and frequency; may be accompanied by autonomic symptoms (pallor, flushing, cyanosis, pupillary dilation, vomiting, diarrhea, sweating, or fever). These disappear during sleep and reappear 10 to 20 minutes after waking and are accompanied by abnormal movements (dystonic attacks and choreoathetosis).
Phase 3 (after age 5): Fixed neurological deficits or regression of primary mental status, especially in the cognitive, attention, language, and behavioral domains, with evidence of attention deficit hyperactivity disorder (ADHD), disruptive behavior, and anxiety disorder. Epileptic seizures usually occur after age 6 in approximately 40 to 50% of patients, without a direct relationship to hemiplegia episodes, and present with atonic, focal motor, or generalized tonic-clonic symptoms.
Other manifestations involve cardiorespiratory abnormalities (cardiac conduction disorder) and endocrinopathies of central origin (precocious puberty and growth hormone deficiency). [6,15-16]
Similar to what has been described in the literature, our patient began experiencing symptoms before 12 months of age, with evidence of developmental delays (gross motor skills and language) and abnormal upward gaze deviation. These clinical manifestations precede hemiplegic episodes, as described by Sandoval 1, Guevara-Campos et al. 4, and Egan [13].
The presented plegic events had an onset at 12 months of age; the first was a diplegic episode, and the second was a hemiplegic episode with hyporeflexia lasting approximately 7 days. The second episode was accompanied by dystonic events after the resolution of the motor deficit. It should be noted that both were triggered: the first by fever related to an exanthematous viral infection (suspected arbovirus), and the second after a prolonged bus trip. Several factors are described as triggers for hemiplegic episodes, including infections and fever, prolonged travel, psychological stress, intense exercise, and other environmental factors (bright light, excessive cold or heat, exposure to very cold or hot water), and certain foods such as chocolate. 9,17 These clinical manifestations coincide with other reported clinical cases where most authors describe hemiplegic attacks as not being the initial symptoms of the disease and appearing in the second phase, accompanied by other abnormal movements. [1, 3-4, 6-7, 9, 13-14]
The diagnosis of AIH is primarily clinical, and the presence or evidence of the genetic alteration or variant is essential to confirm the diagnosis and estimate a prognosis. The clinical criteria were described by Aicardi and Bourgeois 18 and consist of:
a) Start before 18 months of age.
b) Autonomous phenomena.
c) Neurodevelopmental disorders, cognitive and learning difficulties ¬, and/or neurological sequelae such as ataxia, dystonia and choreoathosis ¬.
d) Repeated episodes of hemiplegia that sometimes ¬involve both sides of the body, lasting from minutes to days.
e) Other paroxysmal disorders (abnormal eye movements, diatonic postures).
f) Disappearance of symptoms during sleep and their reappearance upon waking.
g) Exclusion of other disorders that cause recurrent hemiplegia.
Although the criteria proposed an age of onset before 18 months, early studies showed that the age of diagnosis is around 4 years. 19 Typical cases meet criteria a, d, and g. 3, 6. In our case, these criteria were met, so we consider it typical.
The genetic studies to be performed include: ATP1A3 gene sequencing (if there is a high clinical probability), multigene panels targeting dystonias, epilepsies, and other abnormal movements, and genome sequencing in cases not confirmed by the previous studies. In our case, due to limitations in genetic studies, the diagnosis is clinical.
Neuroimaging studies such as CT and MRI, especially MRI, are normal in most patients during acute or recurrent episodes of neurological deficits. However, in a group of children with the classic HAI phenotype, diffuse cerebral or cerebellar atrophy and mesial temporal sclerosis are described. [6]
The EEG during wakefulness and sleep is normal in most cases at the beginning of the disease and during hemiplegic episodes, without paroxysmal activity or registering slow waking activity for their age, as evidenced by other reported cases. [1,3,4,9,14] This was observed in our patient.
The management and treatment of AIH is complex, considering different aspects: acute episodes, prevention, and comorbidities in its evolution. In the acute phase, benzodiazepines, due to their regulatory action on the GABA system, and other sleep inducers (melatonin, chloral hydrate, diphenhydramine, and phenobarbital) could decrease the duration of attacks due to their sleep-promoting effect, but respiratory distress, desaturations, sedation, or behavioral disturbances would have to be taken into account; with controversial results. [6,9]
In preventing seizures, flunarizine is the most commonly used medication and has shown the best results at doses of 5 to 20 mg at night. It has demonstrated efficacy and safety in preventing, reducing the severity and duration (from days to a few hours) of seizures in the long term, with an efficacy rate of approximately 50%. However, it does not alter the prognosis or future course of the condition and is not useful in the treatment of epilepsy or cognitive impairment. Clinical evidence shows that, conversely, patients who did not receive flunarizine experienced severe motor impairment. Other medications used have included topiramate, betamethasone, amantadine, memantine, aripiprazole, oral ATP, coenzyme Q10, acetazolamide, and the ketogenic diet, without demonstrated efficacy. Currently, there are clinical trials underway with cannabidiol. 1-4,6,9-10,14 In our case, we used a dose of 5 mg daily, and in two months of follow-up, the patient only had one seizure of short duration.
The evolution and prognosis of AIH is uncertain and unfavorable in most affected individuals due to its progressive nature, comorbidities, and the frequency and duration of episodes with motor deficits that do not fully recover in most cases after a crisis. Interdisciplinary follow-up by specialists in neurology, genetics, cardiology, endocrinology, psychiatry, rehabilitation, and speech therapy ensures better care and quality of life. [2,5,6,17]
In our patient, from before the first year, there was a delay in DPM, aggravated after the onset of crises with motor deficit that, in similar case reports, [1-2, 5-7, 17,19] required early intervention in stimulation and rehabilitation.
In conclusion, AIH is a rare, enigmatic, and complex disease. Early diagnosis, primarily clinical, requires a thorough medical history, physical examination, and, in some cases, video evidence of episodes with motor deficits. Complementary tests, such as genetic, imaging, and EEG studies, are useful for definitively identifying this condition and establishing a precise differential diagnosis. Early use of flunarizine prevents a worse prognosis by reducing the frequency, severity, and duration of episodes with severe motor deficits, avoiding ineffective treatments, and improving the quality of life for patients and their families.
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Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
