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Congenital Myasthenic Syndromes (CMS) are a rare group of genetic disorders of neuromuscular transmission. Some subtypes of CMS can be associated with respiratory and bulbar weakness and these patients may therefore be at high risk of developing a severe disease from COVID-19. We screened 73 patients with genetically confirmed CMS who were attending the UK national referral centre for evidence of previous Severe Acute Respiratory Syndrome Corona Virus 2 infection and their clinical outcome. Of 73 patients, seven had history of confirmed COVID-19. None of the infected patients developed a severe disease, and there were no signals that CMS alone carries a high risk of severe disease from COVID-19.

Our aim is to describe the difficulties in the diagnosis and treatment of a child with continuous unilateral headache. We present the case of a 12-year-old child who had a two year history of continuous dull pain behind the right ear with frequent episodes of severe sharp pain as well as ipsilateral color change on the cheek. We assess the role of international classification of headache disorders in establishing the diagnosis and we assess the treatment options. The international classification of headache disorders criteria for the diagnosis of hemicrania continua are, based on experience with adults and may not be adequate in children. The child had a very poor quality of life due to his illness and failed to respond to indomethacin among many other medications. However, he responded well to treatment with botulinum toxin type-A on two occasions. Childhood hemicrania continua may have a different phenotype than that in adults. Botulinum toxin type-A may be an option for treatment in some patients.