What is hemiplegia?

Causes and Symptoms

Hemiplegia is paralysis or partial paralysis of one side of the body, typically involving the leg, arm, and trunk. It is caused by damage to or disease of the part of the brain that controls the motor system. The damage may occur prior to birth, during birth, or after birth as a result of an accident, illness, or stroke. The most common cause is a cerebrovascular disease that leads to clotting of the cerebral arteries or bleeding from the diseased arterial wall, eventually producing a stroke. The site most often affected is the internal capsule, where packed nerve fibers descend from the cortex of the brain into the spinal cord.

Immediately after a stroke, the affected body parts are initially limp. In a few days or weeks, the limbs become stiff and spastic. Symptoms of hemiplegia can include paralysis on one side of the body, muscle weakness and spasticity,

poor balance, speech difficulties, epileptic seizures, visual field defects, emotional and behavioral problems, and gait problems, including limping and toe drop. Increased energy expenditure results from compensatory adjustments during walking that produce abnormal movements of the body’s center of gravity.

Treatment and Therapy

Treatments for hemiplegia are designed to improve strength and range of motion, increase bodily functions, and reduce or prevent spasticity. Long-term care is very important. Depending on the severity of the disorder, physical therapy, speech therapy, occupational therapy, braces or orthotics, electrical stimulation, drugs, Botox
injections, or surgery may be used as corrective procedures. Acupuncture and electroacupuncture procedures may be promising treatments for hemiplegia. Children who suffer from hemiplegia may also receive special educational services to help improve specific learning difficulties caused by the disorder. Affected children should involve the weaker side of the body in everyday activities so that they become as two-sided as possible.

Perspective and Prospects

The side of the body affected by hemiplegia depends on which side of the brain has been damaged. The left side of the brain controls the right side of the body, while the right side of the brain controls the left side of the body. Depending on which side of the body is affected, the disease is often referred to as right hemiplegia or left hemiplegia.

Childhood hemiplegia affects up to one child per one thousand. An associated rare neurological disorder, alternating hemiplegia of childhood (AHC), produces periodic transient attacks of hemiplegia that affect one side of the body or the other. An attack of AHC may last from a few minutes up to days. The attacks may alternate from one side of the body to the other. The symptoms are usually relieved with bed rest and proper sleep.

Bibliography

Bobath, Berta. Adult Hemiplegia: Evaluation and Treatment. 3d ed. London: Butterworth/Heinemann, 1998.

Davies, Patricia M. Steps to Follow: The Comprehensive Treatment of Patients with Hemiplegia. 2d ed. New York: Springer, 2004.

"Hemiplegia." Children's Hemiplegia and Stroke Association, 2013.

"Hemiplegia." Christopher and Dana Reeve Foundation, 2011.

Neville, Brian, and Robert Goodman, eds. Congenital Hemiplegia. London: MacKeith, 2001.

"NINDS Alternating Hemiplegia Page." National Institute of Neurological Disorders and Stroke, September 16, 2011.

Spivack, Barney S., ed. Evaluation and Management of Gait Disorders. New York: Marcel Dekker, 1995.