Hemiplegia is total paralysis of the arm, leg, and trunk on the opposite side of the body to brain damage. Hemiplegia is more severe than hemiparesis, where in one half of the body has less marked weakness. Hemiplegia and Hemiparesis may be congenital, or they might be acquired conditions resulting from an illness, an injury, or a stroke.
Signs and Symptoms
Hemiplegia means severe weakness of the limbs on one side of the body but the specific features can vary tremendously from person to person. Problems may include: Difficulty with gait
- Difficulty with balance while standing orwalking
- Having difficulty with motor activities like holding, grasping or pinching
- Increasing stiffness of muscles
- Muscle spasms
- The majority of children who develop hemiplegia also have abnormal mental development
- Behavior problems like anxiety, anger, irritability, lack ofconcentration or comprehension
- Emotions —depression
- Shoulder hand syndrome
Cause
The most common cause of hemiplegia is stroke. Strokes can cause a variety of movement disorders, depending on the location and severity of the lesion. Hemiplegia is common when the stroke affects the corticospinal tract. Other causes of hemiplegia include spinal cord injury, specifically Brown-Séquard syndrome, traumatic brain injury, or disease affecting the brain.
The incidence of hemiplegia is much higher in premature babies than term babies. There is also a high incidence of hemiplegia during pregnancy and experts believe that this may be related to either a traumatic delivery, use of forceps or some event which causes brain injury.
Other causes of hemiplegia in adults include trauma, bleeding, brain infections and cancers. Individuals who have uncontrolled diabetes,hypertension or those who smoke have a higher chance of developing a stroke. Weakness on one side of the face may occur and may bedue to a viral infection, stroke or a cancer.[4]
Medial medullary syndrome
Common causes by etiology
- Vascular:cerebral hemorrhage,[5] stroke, diabetic neuropathy
- Infective:encephalitis, meningitis, brain abscess
- Neoplastic:glioma–meningioma
- Demyelination:disseminated sclerosis, lesions to the internal capsule
- Traumatic:cerebral lacerations, subdural hematoma rare cause of hemiplegia is due to local anaesthetic injections given intra-arteriallyrapidly, instead of given in a nerve branch.
- Congenital:cerebral palsy
- Disseminated:multiple sclerosis
- Psychological:parasomnia (nocturnal hemiplegia0
Rehabilitation
Rehabilitation is the main treatment of individuals with hemiplegia. In all cases, the major aim of rehabilitation is to regain maximum functional quality of life. Both physical and occupational therapy can significantly improve the quality of life.
Physiotherapy
Physiotherapy can help improve muscle strength & coordination, mobility (such as standing and walking), and other physical function using different sensori-motor techniques. Physiotherapists can also help reduce shoulder pain by maintaining shoulder range of motion, aswell as using Functional electrical stimulation. Supportive devices, such as braces or slings, can be used to help prevent or treat shoulder subluxation, in the hopes to minimize disability and pain. It should be noted that although many individuals suffering from stroke experience both shoulder pain and shoulder subluxation, the two are mutually exclusive. A treatment method that can be implemented with the goal of helping to regain motor function in the affected limb is constraint induced movement therapy. This consists of constraining the unaffected limb, forcing the affected limb to accomplish tasks of daily living.