Hemiplegia

Hemiplegia is a condition in which half of a body has compromised motoric functions. Hemiplegia is more severe than hemiparesis, wherein one half of the body is weakened but not paralysed. 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. The most common cause of hemiplegia is a cerebrovascular accident, also known as a stroke. Strokes may also cause less severe conditions like hemiparesis and spasticity, however these could be minimized through rigorous post-trauma physical therapy.Alternate causes of hemiplegia include any spinal cord injury, specifically Brown-Séquard syndrome, traumatic brain injury, or other disease affecting the central nervous system. Injury to only one of the cerebral hemispheres is more likely to cause hemiplegia. In cerebral palsy, damage to the hemisphere may limit function or cause spasticity without resulting in total paralysis of one half of the body.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 infections and cancers. Individuals who have uncontrolled diabetes, hypertension or those who smoke have a higher chance of developing a stroke. In some cases, only the face may be paralyzed. Facial hemiplegia may occur on one side of the face and may be due to a viral infection, stroke or a cancer.                                                    Pathogenesis: The exact cause of hemiplegia is not known in all cases, but it appears that in all cases the brain is deprived of oxygen and this results in the death of neurons, leading to hemiplegia. When hemiplegia occurs, 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.                                                                                                                                                   Hemiplegia means paralysis of one side of the body but the clinical features can vary tremendously. Rehabilitation is the main treatment of individuals with hemiplegia. In all cases, the major aim of rehabilitation is to regain maximum functioning potential of the brain. Both physical and occupational therapy can significantly improve the quality of life. Physical therapy can help improve the range of motion, increase muscle strength and prevent joint contractures. Occupational therapy may help the individual perform 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.