Hemiplegia

Hemiplegia is when one side of the body is paralysed. It can affect either side of the body and is caused by damage to the brain, such as a stroke.
This can happen in babies, before, during or after birth. The condition can be congenital or acquired. No one knows what causes the damage in these cases.
Hemiplegia can also be acquired.
This is caused by damage to the brain, such as a stroke. In childhood or traumatic injury to brain during child birth such as forceps delivery.
This condition can affect any child, but it is slightly more common in premature babies. It is quite a common condition, affecting one in 1000 births.
Sometimes the condition will only become clear as the baby gets older, such as when they have trouble walking.

1. About Hemiplegia

Hemiplegia is when one side of the body is paralysed. The condition can be congenital – or acquired. And it can affect either side of the body. It can occur in babies, children or adults, – and if acquired, can caused by damage to the brain, either by forceps being used during delivery – or a stroke etc.

An injury to the right side of the brain will cause the left side of the body to be paralysed.
An injury to the left side of the brain will cause the right side of the body to be paralysed.
Sometimes the condition will only become clear as the baby gets older, such as when they have trouble walking

2. Hemiplegia in Children

i. Signs and Symptoms

The main symptom of hemiplegia is weakness or paralysis on one side of the child’s body. The condition can vary in severity and affects each child differently.
General symptoms include: difficulty walking, poor balance and little or no use of one hand or leg.

The condition affects the brain. This means that there may be other associated symptoms, such as:
– speech problems
– visual problems
– behavioural problems
– learning difficulties
– epilepsy
– developmental delay, for example learning to walk later than other children.

ii. How is it Diagnosed and Treated

A doctor will examine the child for signs of paralysis. A Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) scan of the brain can look for a brain injury. It is often difficult for a doctor to determine how mild or severe the condition is. It may be a case of having to wait and see how each child develops over time.
Once diagnosed, Hemiplegia cannot be cured, treatment will focus on managing the symptoms and improving quality of life.

A child’s brain will often re-wire itself to a certain degree. This means that some brain function can be taken over by unaffected parts of the brain.
– Physiotherapy will help the child to build up the weakened side of their body to improve function.
– Occupational therapy can teach them how to cope with everyday activities.
– Speech therapy may also be necessary for some children.
– As the child gets older it will become clearer how mild or severe their condition is.
This will be shown in certain developmental milestones, such as walking, which they may reach slightly later than other children.
– Children with Hemiplegia will learn their abilities as they develop & grow.
– Regular physical therapy can help them live a normal life.

3. Hemiplegia in Adults

Hemiplegia in adults can result from a variety of causes:
Stroke: In adults stroke is the commonest cause. It is more after the age of 50, but can occur before this age also. Stroke results from insufficient or decreased supply of blood to brain. As a result the cells are deprived of vital oxygen and they progressively die. Blood supply can be restricted due to either:
– A clot in blood vessels of brain (thrombus).
– An emboli originating elsewhere and lodging itself in blood vessels of brain (embolism)
– Leakage of blood from brain vessels (hemorrhage).

Severe trauma on head resulting in hemorrhage.
Infections such as meningitis, brain abscess & encephalitis.
Tumor inside brain.
Hypertension and diabetes
Diseases that involves nerves such as multiple scelrosis or myelits.

i. Signs and Symptoms Of Hemiplegia In Adults

The nerves cross its pathway in other direction from certain point from its origin the brain, thus an injury to right of brain results in left sided Hemiplegia and vice versa. These nerve cells then join the spinal cord.

– It is usually an acute episode.
Patient experiences difficulty in walking, There limbs are paralyzed, they are unable to move one side of their hand and leg. They are not able to balance themselves.
The muscles of throat are also paralyzed, and the individual finds difficulty in swallowing.
This also causes the speech to become slurred.
– There is drooping of saliva from angle of mouth and the eyesight is affected. It may lead to drooping of eyelids of one side.
There is tingling numbness in affected limbs and loss of bladder and bowel control.
– Thumb gets folded in palm and fingers clasp the thumb of affected side.
Memory becomes poor and is unable to recall past or present events.

The clinical picture itself is suggestive of Hemiplegia, however to find the underlying cause, several tests are done such as
CT scan, MRI, blood tests, spinal fluid examination, etc.

4. Treatment and Physiotherapy For Hemiplegia 

Treatment of hemiplegia requires coordination of several health professionals.
A physiotherapist, occupational therapists, a physician, a surgeon and support from family etc.
Treatment is focused on finding the causative factor. Rehabilitation therapy helps to minimize disability.
Several medicines are prescribed to control the primary cause including anti hypertensive, anti-thrombolytic agents to dissolve the clot, and drugs to control cerebral edema etc.
Intensive physical therapy begins a few days later. Activities such as walking and standing are done repeatedly under the guidance of physiotherapist.
This helps improve the muscular functions which have become rigid.
The aim is to make the patient as self sufficient as possible and able to perform his daily activities.
The patient is taught to move his affected arm with his strong arm. With such exercise it is possible to maintain flexibility of joints and also prevents tightening and shortening of muscles. Speech therapy is simultaneously begun to improve communication and speaking skills.

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