Hemiplegia is paralysis (the loss of motor function) on one side of the body. Hemiparesis has similar causes, but results in severe to moderate weakness of motor function on one side of the body. Stroke, embolism, aneurysm or traumatic brain injury are the most common causes of hemiplegia or hemiparesis. The loss of motor function manifests on the opposite side of the body from where the damage in the brain occurs. Typically, for hemiplegia, damage has occurred in the corticospinal tract. Brain injury, brain infection, brain diseases, spinal cord and nerve diseases or injury, cancer or tumors in the brain, and injury during birth can also result in this type of paralysis or weakness of motor function. When the brain suffers oxygen deprivation, and the resultant neurological damage impedes communication from the brain to the nerves, motor control is affected. If your child suffers from hemiplegia or hemiparesis, you should have the birth records reviewed by an attorney specializing in medical negligence and birth injury.
In infants and young children, hemiplegia is usually attributed to cerebral palsy if no other cause such as brain or spinal cord trauma or infection is evident. Approximately one child in every 1,000 births has hemiplegia. Premature babies are at a higher risk of hemiplegia. Although fetuses and newborns can be affected by periventricular leukomalacia (cysts or lesions in the brain near the central brain artery that cause white matter death), the risk to premature infants is much higher because of additional complications from being born without a fully developed physiology. The high occurrence of hemiplegia during birth is thought to be related to trauma during delivery, forceps injury or some other acute injury.
Children with hemiplegia may have difficulty walking and balancing, performing fine motor skills, and controlling their limbs on one side of the body. They may also experience stiffness and reduced endurance or weakness in muscles, and possibly have seizures. The severity and types of symptoms depends on what part of the brain or central nervous system has sustained damage, and to what degree. Although imaging scans (CT or ultrasound) of the brain and spinal cord can be used to confirm the presence of damage to the brain or spinal cord, the actual dysfunctions in motor control must be analyzed by a doctor or physiotherapist to make a diagnosis of hemiplegia.
Hemiplegia is not a condition that worsens, but secondary problems can develop as a result of the reduction or loss of motor control. For example, individuals who are confined to a mobility device may develop pressure sores. In addition, overall cardiovascular health can be at risk, as well as muscle strength, flexibility and joint mobility.
Medications can reduce muscle stiffness and spasticity. Anti-seizure medications are generally successful in reducing the number and severity of seizures. Physical therapy and rehabilitation are the most important treatments to help improve quality of life for those with hemiplegia. Children typically undergo speech therapy to improve their ability to speak and process speech, wear braces or splints for stability in walking to aid in muscle development, undergo surgery to relieve joint contractures, and take part in occupational therapy and independence training to deal with activities of day-to-day living. Early physical therapy intervention is crucial for the child to gain as much independence as possible. Thanks to developmental processes that happen throughout childhood and through appropriate physical therapy, a child’s brain may be able to “rewire” some of the lost neural pathways and have better use of motor capabilities than an individual who suffers an injury leading to hemiplegia as an adult.