Hemiplegia
Encyclopedia
Hemiplegia /he.mə.pliː.dʒiə/ is total paralysis of the arm, leg, and trunk on the same side of the body. Hemiplegia is more severe than hemiparesis
, wherein one half of the body has less marked weakness.
Hemiplegia may be congenital or acquired from an illness or stroke
.
Hemiplegia is not an uncommon medical disorder. In elderly individuals, strokes are the most common cause of hemiplegia. In children, the majority of cases of hemiplegia have no identifiable cause and occur with a frequency of about one in every thousand births. Experts indicate that the majority of cases of hemiplegia that occur up to the age of two should be considered to be cerebral palsy
until proven otherwise.
. 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
. As a lesion
that results in hemiplegia occurs in the brain or spinal cord, hemiplegic muscles display features of the Upper Motor Neuron Syndrome. Features other than weakness include decreased movement control, clonus (a series of involuntary rapid muscle contractions), spasticity
, exaggerated deep tendon reflexes and decreased endurance.
It is well known that the incidence of hemiplegia is a lot 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.
Hemiplegia in adults include trauma
, bleeding
, brain infection
s and cancer
s. 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 be due to a viral infection, stroke or a cancer.
and this results in the death of neurons. When the corticospinal tract is damaged, the injury is usually manifested on the opposite side of the body. For example if one has an injury to the right side of the brain, the hemiplegia will be on the left side of the body.
of the brain should be used to confirm injury in the brain and spinal cord, but alone cannot be used to identify movement disorders. Individuals who develop seizure
s may undergo tests to determine where the focus of excess electrical activity is.
Hemiplegia patients usually show a characteristic gait. The leg on the affected side is extended and internally rotated and is swung in a wide, lateral arc rather than lifted in order to move it forward. The upper limb on the same side is also adducted at the shoulder, flexed at the elbow, and pronated at the wrist with the thumb tucked into the palm and the fingers curled around it.
Drugs can be used to treat issues related to the Upper Motor Neuron Syndrome. Drugs like Librium
or Valium
could be used as a relaxant. Drugs are also given to individuals whom have recurrent seizures, which may be a separate but related problem after brain injury
.
Surgery may be used if the individual develops a secondary issue of contracture
, from a severe imbalance of muscle activity. In such cases the surgeon
may cut the ligament
s and relieve joint contractures. Individuals who are unable to swallow may have a tube inserted into the stomach. This allows food to be given directly into the stomach. The food is in liquid form and instilled at low rates.
Prosthetics. Some individuals with hemiplegia will benefit from some type of prosthetic
device. There are many types of braces and splints available to stabilize a joint, assist with walking and keep the upper body erect.
Rehabilitation is the main treatment of individuals with hemiplegia. In all cases, the major aim of rehabilitation is to regain maximum function and quality of life. Both physical and occupational therapy
can significantly improve the quality of life. Physical therapy
can help improve muscle strength, mobility such as standing and walking, and other physical function. Occupational therapy
may help the individual train daily living activities like brushing teeth, combing hair or dressing. Initially, one may undergo physical therapy at a center but many of these exercises can also be done at home and become part of daily life routine. A treatment method that can be implement with the goal of helping to regain motor function in the affected limb is constraint-induced movement therapy
. Treatments consist of constraining the unaffected limb, forcing the affected limb to accomplish tasks of daily living.
There are a variety of standardized assessment scales available to physiotherapists and other health care professionals for use in the ongoing evaluation of the status of a patient’s hemiplegia. The use of standardized assessment scales may help physiotherapists and other health care professionals during the course of their treatment plant to:
- Prioritize treatment interventions based on specific identifiable motor and sensory deficits
- Create appropriate short and long term goals for treatment based on the outcome of the scales, their professional expertise and the desires of the patient
- Evaluate the potential burden of care and monitor any changes based on either improving or declining scores
Three of the most commonly used scales in the assessment of hemiplegia are:
1. The Fugl-Meyer Assessment of Physical Performance (FMA)
-The FMA is often used as a measure of functional or physical impairment following a cerebrovascular accident(CVA). It measures sensory and motor impairment of the upper and lower extremities, balance in several positions, range of motion, and pain. This test is a reliable and valid measure in measuring post-stroke impairments related to stroke recovery. A lower score in each component of the test indicates higher impairment and a lower functional level for that area. The maximum score for each component is 66 for the upper extremities, 34 for the lower extremities, and 14 for balance.
2. The Chedoke-McMaster Stroke Assessment (CMSA)
-This test is a reliable measure of two separate components evaluating both motor impairment and disability
. The disability component assesses any changes in physical function including gross motor function and walking ability. The disability inventory can have a maximum score of 100 with 70 from the gross motor index and 30 from the walking index. Each task in this inventory has a maximum score of seven except for the 2 minute walk test which is out of two. The impairment component of the test evaluates the upper and lower extremities, postural control and pain. The impairment inventory focuses on the seven stages of recovery from stroke from flaccid paralysis
to normal motor functioning.
3. The STroke REhabilitation Assessment of Movement (STREAM)
The STREAM consists of 30 test items involving upper-limb movements, lower-limb movements, and basic mobility items. It is a clinical measure of voluntary movements and general mobility (rolling, bridging, sit-to-stand, standing, stepping, walking and stairs) following a stroke. The voluntary movement part of the assessment is measured using a 3-point ordinal scale (unable to perform, partial performance, and complete performance) and the mobility part of the assessment uses a 4-point ordinal scale (unable, partial, complete with aid, complete no aid). The maximum score one can receive on the STREAM is a 70 (20 for each limb score and 30 for mobility score). The higher the score, the better movement and mobility is available for the individual being scored.
.
Sudden recovery from hemiplegia is very rare. Many of the individuals will have limited recovery, but the majority will improve from intensive, specialised rehabilitation. Potential to progress may differ in cerebral palsy, compared to adult acquired brain injury. It is vital to integrate the hemiplegic child into society and encourage them in their daily living activities. With time, some individuals may make remarkable progress.
Hemiparesis
Hemiparesis is weakness on one side of the body. It is less severe than hemiplegia - the total paralysis of the arm, leg, and trunk on one side of the body. Thus, the patient can move the impaired side of his body, but with reduced muscular strength....
, wherein one half of the body has less marked weakness.
Hemiplegia may be congenital or acquired from an illness or stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
.
Hemiplegia is not an uncommon medical disorder. In elderly individuals, strokes are the most common cause of hemiplegia. In children, the majority of cases of hemiplegia have no identifiable cause and occur with a frequency of about one in every thousand births. Experts indicate that the majority of cases of hemiplegia that occur up to the age of two should be considered to be cerebral palsy
Cerebral palsy
Cerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement....
until proven otherwise.
Causes
The most common cause of hemiplegia is strokeStroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
. Strokes can cause a variety of movement disorders, depending on the location and severity of the lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
. Hemiplegia is common when the stroke affects the corticospinal tract
Corticospinal tract
The corticospinal or pyramidal tract is a collection of axons that travel between the cerebral cortex of the brain and the spinal cord....
. Other causes of hemiplegia include spinal cord injury
Spinal cord injury
A spinal cord injury refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence...
, specifically Brown-Séquard syndrome
Brown-Séquard syndrome
Brown-Séquard syndrome, also known as Brown-Séquard's hemiplegia and Brown-Séquard's paralysis, is a loss of sensation and motor function that is caused by the lateral hemisection of the spinal cord...
, traumatic brain injury
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
, or disease affecting the brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
. As a lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
that results in hemiplegia occurs in the brain or spinal cord, hemiplegic muscles display features of the Upper Motor Neuron Syndrome. Features other than weakness include decreased movement control, clonus (a series of involuntary rapid muscle contractions), spasticity
Spasticity
Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles...
, exaggerated deep tendon reflexes and decreased endurance.
It is well known that the incidence of hemiplegia is a lot higher in premature babies than term babies. There is also a high incidence of hemiplegia during pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
and experts believe that this may be related to either a traumatic delivery, use of forceps
Forceps
Forceps or forcipes are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term 'forceps' is used almost exclusively...
or some event which causes brain injury.
Hemiplegia in adults include trauma
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
, bleeding
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
, brain infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
s and cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
s. Individuals who have uncontrolled diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
, hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
or those who smoke have a higher chance of developing a stroke. Weakness on one side of the face may occur and may be due to a viral infection, stroke or a cancer.
Common causes by etiology
- Vascular: cerebral hemorrhage, stroke, diabetic neuropathyDiabetic neuropathyDiabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. These conditions are thought to result from diabetic microvascular injury involving small blood vessels that supply nerves in addition to macrovascular conditions that can culminate in diabetic neuropathy...
- Infective: encephalitisEncephalitisEncephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...
, meningitisMeningitisMeningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs...
, brain abscessBrain abscessBrain abscess is an abscess caused by inflammation and collection of infected material, coming from local or remote infectious sources, within the brain tissue... - Neoplastic: gliomaGliomaA glioma is a type of tumor that starts in the brain or spine. It is called a glioma because it arises from glial cells. The most common site of gliomas is the brain.-By type of cell:...
-meningiomaMeningiomaThe word meningioma was first used by Harvey Cushing in 1922 to describe a tumor originating from the meninges, the membranous layers surrounding the CNS .... - Demyelination: disseminated sclerosis, lesions to the internal capsuleInternal capsuleThe internal capsule is an area of white matter in the brain that separates the caudate nucleus and the thalamus from the lenticular nucleus. The internal capsule contains both ascending and descending axons....
- Traumatic: cerebral lacerations, subdural hematomaSubdural hematomaA subdural hematoma or subdural haematoma , also known as a subdural haemorrhage , is a type of haematoma, a form of traumatic brain injury. Blood gathers within the outermost meningeal layer, between the dura mater, which adheres to the skull, and the arachnoid mater, which envelops the brain...
rare cause of hemiplegia is due to local anaesthetic injections given intra-arterially rapidly, instead of given in a nerve branch. - Congenital: cerebral palsy
- Disseminated: multiple sclerosisMultiple sclerosisMultiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
- Psychological: parasomniaParasomniaFor the 2008 horror film, see Parasomnia Parasomnias are a category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep...
(nocturnal hemiplegia)
Pathogenesis
The exact cause of hemiplegia is not known in all cases, but it appears that the brain is deprived of oxygenOxygen
Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition...
and this results in the death of neurons. When the corticospinal tract is damaged, the injury is usually manifested on the opposite side of the body. For example if one has an injury to the right side of the brain, the hemiplegia will be on the left side of the body.
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 gaitGaitGait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency...
- Difficulty with balance while standing or walking
- Having difficulty with motorMotor skillA motor skill is a learned sequence of movements that combine to produce a smooth, efficient action in order to master a particular task. The development of motor skill occurs in the motor cortex, the region of the cerebral cortex that controls voluntary muscle groups.- Development of motor skills...
activities like holding, grasping or pinching - Increasing stiffnessStiffnessStiffness is the resistance of an elastic body to deformation by an applied force along a given degree of freedom when a set of loading points and boundary conditions are prescribed on the elastic body.-Calculations:...
of muscles - Muscle spasmSpasmIn medicine a spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. It is sometimes accompanied by a sudden burst of pain, but is usually harmless and ceases after a few minutes...
s - Difficulty with speech
- Difficulty swallowingSwallowingSwallowing, known scientifically as deglutition, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. If this fails and the object goes through the trachea, then choking or pulmonary aspiration...
food - Significant delay in achieving developmental milestones like standing, smiling, crawling or speaking
- The majority of children who develop hemiplegia also have abnormal mental development
- Behavior problems like anxiety, anger, irritability, lack of concentration or comprehension
- Emotions- depression
Diagnosis
Hemiplegia is identified by clinical examination by a health professional, such as a physiotherapist or doctor. Radiological studies like a CT scan or magnetic resonance imagingMagnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
of the brain should be used to confirm injury in the brain and spinal cord, but alone cannot be used to identify movement disorders. Individuals who develop seizure
Seizure
An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
s may undergo tests to determine where the focus of excess electrical activity is.
Hemiplegia patients usually show a characteristic gait. The leg on the affected side is extended and internally rotated and is swung in a wide, lateral arc rather than lifted in order to move it forward. The upper limb on the same side is also adducted at the shoulder, flexed at the elbow, and pronated at the wrist with the thumb tucked into the palm and the fingers curled around it.
Treatment
Treatment should be based on assessment by the relevant health professionals, including physiotherapists, doctors and occupational therapists. Muscles with severe motor impairment including weakness need these therapists to assist them with specific exercise, and are likely to require help to do this.Drugs can be used to treat issues related to the Upper Motor Neuron Syndrome. Drugs like Librium
Chlordiazepoxide
Chlordiazepoxide, is a sedative/hypnotic drug and benzodiazepine. It is marketed under the trade names Angirex, Klopoxid, Librax , Libritabs, Librium, Mesural, Multum, Novapam, Risolid, Silibrin, Sonimen and Tropium.Chlordiazepoxide was the first benzodiazepine to be synthesised and...
or Valium
Diazepam
Diazepam , first marketed as Valium by Hoffmann-La Roche is a benzodiazepine drug. Diazepam is also marketed in Australia as Antenex. It is commonly used for treating anxiety, insomnia, seizures including status epilepticus, muscle spasms , restless legs syndrome, alcohol withdrawal,...
could be used as a relaxant. Drugs are also given to individuals whom have recurrent seizures, which may be a separate but related problem after brain injury
Brain injury
A brain injury is any injury occurring in the brain of a living organism. Brain injuries can be classified along several dimensions. Primary and secondary brain injury are ways to classify the injury processes that occur in brain injury, while focal and diffuse brain injury are ways to classify...
.
Surgery may be used if the individual develops a secondary issue of contracture
Contracture
A muscle contracture is a permanent shortening of a muscle or joint.. It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spastic cerebral palsy....
, from a severe imbalance of muscle activity. In such cases the surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
may cut the ligament
Ligament
In anatomy, the term ligament is used to denote any of three types of structures. Most commonly, it refers to fibrous tissue that connects bones to other bones and is also known as articular ligament, articular larua, fibrous ligament, or true ligament.Ligament can also refer to:* Peritoneal...
s and relieve joint contractures. Individuals who are unable to swallow may have a tube inserted into the stomach. This allows food to be given directly into the stomach. The food is in liquid form and instilled at low rates.
Prosthetics. Some individuals with hemiplegia will benefit from some type of prosthetic
Prosthesis
In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...
device. There are many types of braces and splints available to stabilize a joint, assist with walking and keep the upper body erect.
Rehabilitation is the main treatment of individuals with hemiplegia. In all cases, the major aim of rehabilitation is to regain maximum function and quality of life. Both physical and occupational therapy
Occupational therapy
Occupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments...
can significantly improve the quality of life. Physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
can help improve muscle strength, mobility such as standing and walking, and other physical function. Occupational therapy
Occupational therapy
Occupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments...
may help the individual train daily living activities like brushing teeth, combing hair or dressing. Initially, one may undergo physical therapy at a center but many of these exercises can also be done at home and become part of daily life routine. A treatment method that can be implement with the goal of helping to regain motor function in the affected limb is constraint-induced movement therapy
Constraint-induced movement therapy
Constraint-induced movement therapy is a form of rehabilitation therapy that improves upper extremity function in stroke and other Central Nervous System damage victims by increasing the use of their affected upper limb....
. Treatments consist of constraining the unaffected limb, forcing the affected limb to accomplish tasks of daily living.
There are a variety of standardized assessment scales available to physiotherapists and other health care professionals for use in the ongoing evaluation of the status of a patient’s hemiplegia. The use of standardized assessment scales may help physiotherapists and other health care professionals during the course of their treatment plant to:
- Prioritize treatment interventions based on specific identifiable motor and sensory deficits
- Create appropriate short and long term goals for treatment based on the outcome of the scales, their professional expertise and the desires of the patient
- Evaluate the potential burden of care and monitor any changes based on either improving or declining scores
Three of the most commonly used scales in the assessment of hemiplegia are:
1. The Fugl-Meyer Assessment of Physical Performance (FMA)
-The FMA is often used as a measure of functional or physical impairment following a cerebrovascular accident(CVA). It measures sensory and motor impairment of the upper and lower extremities, balance in several positions, range of motion, and pain. This test is a reliable and valid measure in measuring post-stroke impairments related to stroke recovery. A lower score in each component of the test indicates higher impairment and a lower functional level for that area. The maximum score for each component is 66 for the upper extremities, 34 for the lower extremities, and 14 for balance.
2. The Chedoke-McMaster Stroke Assessment (CMSA)
-This test is a reliable measure of two separate components evaluating both motor impairment and disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
. The disability component assesses any changes in physical function including gross motor function and walking ability. The disability inventory can have a maximum score of 100 with 70 from the gross motor index and 30 from the walking index. Each task in this inventory has a maximum score of seven except for the 2 minute walk test which is out of two. The impairment component of the test evaluates the upper and lower extremities, postural control and pain. The impairment inventory focuses on the seven stages of recovery from stroke from flaccid paralysis
Flaccid paralysis
Flaccid paralysis is a clinical manifestation characterized by weakness or paralysis and reduced muscle tone without other obvious cause .-Polio:...
to normal motor functioning.
3. The STroke REhabilitation Assessment of Movement (STREAM)
The STREAM consists of 30 test items involving upper-limb movements, lower-limb movements, and basic mobility items. It is a clinical measure of voluntary movements and general mobility (rolling, bridging, sit-to-stand, standing, stepping, walking and stairs) following a stroke. The voluntary movement part of the assessment is measured using a 3-point ordinal scale (unable to perform, partial performance, and complete performance) and the mobility part of the assessment uses a 4-point ordinal scale (unable, partial, complete with aid, complete no aid). The maximum score one can receive on the STREAM is a 70 (20 for each limb score and 30 for mobility score). The higher the score, the better movement and mobility is available for the individual being scored.
Prognosis
Hemiplegia is not a progressive disorder, except in progressive conditions like a growing brain tumour. Once the injury has occurred, the symptoms should not worsen. However, because of lack of mobility, other complications can occur. Complications may include muscle and joint stiffness, loss of aerobic fitness, muscle spasms, bed sores, pressure ulcers and blood clotsThrombus
A thrombus , or blood clot, is the final product of the blood coagulation step in hemostasis. It is achieved via the aggregation of platelets that form a platelet plug, and the activation of the humoral coagulation system...
.
Sudden recovery from hemiplegia is very rare. Many of the individuals will have limited recovery, but the majority will improve from intensive, specialised rehabilitation. Potential to progress may differ in cerebral palsy, compared to adult acquired brain injury. It is vital to integrate the hemiplegic child into society and encourage them in their daily living activities. With time, some individuals may make remarkable progress.
Hemiplegia in popular culture
- In Barbara KingsolverBarbara KingsolverBarbara Kingsolver is an American novelist, essayist and poet. She was raised in rural Kentucky and lived briefly in the former Republic of Congo in her early childhood. Kingsolver earned degrees in biology at DePauw University and the University of Arizona and worked as a freelance writer before...
's novel, Poisonwood Bible, the character Adah is incorrectly diagnosed, in childhood, as having hemiplegia.
See also
- alternating hemiplegiaAlternating hemiplegiaAlternating hemiplegia refers to a form of hemiplegia that has an ipsilateral and contralateral presentation in different parts of the body. The disorder is characterized by recurrent episodes of paralysis on one side of the body. This type of syndrome can result from a unilateral lesion in the...
- hemiplegic migraine
- laryngeal paralysisLaryngeal paralysisLaryngeal paralysis in animals is a condition in which the nerves and muscles that control the movements of one or both arytenoid cartilages of the larynx cease to function, and instead of opening during inspiration and closing during swallowing, the arytenoids remain stationary in a somewhat...
- ParaplegiaParaplegiaParaplegia is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek: παραπληγίη "half-striking". It is usually the result of spinal cord injury or a congenital condition such as spina bifida that affects the neural elements of the spinal canal...
- spasticitySpasticitySpasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles...
- Brunnstrom ApproachBrunnstrom Approach-History:The Brunnstrom Approach, developed by the Swedish physical therapist Signe Brunnstrom, emphasises the synergic pattern of movement which develops during recovery from hemiplegia...
- constraint-induced movement therapyConstraint-induced movement therapyConstraint-induced movement therapy is a form of rehabilitation therapy that improves upper extremity function in stroke and other Central Nervous System damage victims by increasing the use of their affected upper limb....
External links
- CHASA Children's Hemiplegia and Stroke Association non-profit organization
- HemiHelp, a UK based childhood hemiplegia (cerebral palsy) charity
- http://www.katyroberts.co.uk/all_about_me/living_with_hemiplegia.htm Living with hemiplegia a child's perspective by Katy Roberts who suffers from left sided hemiplegia.
- AHC Kids Dutch website about Alternating Hemiplegia of Childhood
- Spinal Cord Injury Peer Support
- Hemiplegia and associated problems
- Wrong Diagnosis.com General Hemiplegia Info, Tools & Discussion Boards
- Video of hemiplegic gait and other gait abnormalities
- Chedoke-McMaster Stroke Assessment
- http://www.medicalnewstoday.com/articles/55547.php Constraint-Induced Movement Therapy Is Effective In Rehabilitating Stroke Patients