Hemiplegia (or hemiphlegia)
Hemiplegia (or hemiphlegia ) is a condition where a vertical half of a patient’s body is weak or paralyzed, i.e. one arm and its corresponding leg do not function properly.
It can be congenital (occurring before, during, or soon after birth) or acquired (as from illness or stroke). It is usually the result of a stroke, although disease processes affecting the spinal cord and other diseases affecting the hemispheres are equally capable of producing this clinical state.
Cerebral palsy can also affect one hemisphere, resulting in limited function. This does not cause paralysis but instead causes spasms. Cerebral palsy where this is the only symptom is often referred just as hemiplegia.
Hemiplegia is similar to hemiparesis, but hemiparesis is considered less severe.
“The majority of children with hemiplegia have normal intelligence, go to regular, age-appropriate schools, can expect to have a relatively normal function as adults, and have few problems beyond the physical difficulties of the arm and leg that are involved.”
Hemiplegia has also been used to describe children with mild involvement of one limb (monoplegia), or involvement of three limbs (triplegia). Double hemiplegia is sometimes used to describe cerebral palsy that affects all four limbs but effects the right and left sides in different ways.
In most hemiplegia cases, the arm is usually more affected than the leg, and the problems are usually worse at the end of a limb.
The child typically has a harder time with hand, wrist, ankle, and foot movement than with elbow, knee and shoulder movements. Significant problems arise related to the specificity and growth of these muscles.
Left- or right-hand preference is usually not well established until 18 to 24 months of age in an average child, so if your child is showing a preference to one hand before this time period may be a sign of hemiplegia.
Other early signs to watch out for include a visibly stronger limb, a hand or thumb held in a fist, or when they start sitting or standing, falling to the side affected by CP. Most children with classic hemiplegia eventually become good sitters.
A child with hemiplegia may start walking late and may first start walking on tiptoe. They also may grow out of this.
Unless they are persistent, special braces or shoes are not necessary, though if your child is having problems moving or crawling, this is a good time to start seeing a physical or occupational therapist.
After a child is diagnosed with hemiplegia, a full neurological evaluation is necessary to discern if other conditions are present and to make sure no other condition, such as a brain tumor, is causing the child’s symptoms.
Caring for a child with hemiplegia is not much different from caring for a child without a disability, though talking with an occupational therapist to determine proper levels of expectations is a good idea.
It is recommended to give your child toys that require two hands to stimulate the use of the involved hand. Encourage her to use the involved hand, but don’t push her to the point of frustration or force her to do things she is not able to.