Hemiplegia in medical parlance is complete paralysis of one side of the body. The word ‘hemi’ means one sided, and meaning of ‘plegia’ is severe weakness. In hemiplegia one side of arm and leg are paralyzed including one side of face. Hemiplegia occurs when the brain cells are damaged. It can result from an injury or infection in brain.
Since the half of body is paralyzed, patient is unable to walk and balance himself. He may have difficulty in swallowing and has slurred speech. He may lose control over urination and stool.Usually the onset is sudden and the condition is diagnosed clinically. Other tests such as CT scan of brain or spine will confirm the cause that triggered hemiplegia.
It takes months for patient to recover from hemipelgia. Treatment is focused on control of progression of underlying cause and rehabilitation therapy where exercise plays a vital role.
Causes Of Hemiplegia In Adults
Hemiplegia in adults can result from many underlying causes. Below are given several 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 (1) a clot in blood vessels of brain (thrombus). (2) An emboli originating elsewhere and lodging itself in blood vessels of brain (embolism), or (3) Leakage of blood from brain vessels (hemorrhage).
- Severe trauma on head resulting in hemorrhage.
- Infections such as meningitis, brain abscess and encephalitis.
- Tumor inside brain.
- Hypertension and diabetes.
- Diseases that involves nerves such as multiple scelrosis, myelits.
- In children traumatic injury to brain during child birth such as forceps delivery etc.
Signs And Symptoms Of Hemiplegia
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, his limbs are paralyzed. He is unable to move one side of his hand and leg. He is not able to balance himself. At the same time as the muscles of throat are paralyzed, he finds difficulty in swallowing. His speech becomes slurred.
- There is drooping of saliva from angle of mouth. His eyesight is affected. It may lead to drooping of eyelids of one side. There is tingling numbness in affected limbs. Loss of bladder and bowel control as a result patient is unable to hold on urine and stool.
- Thumb gets folded in palm and fingers clasp the thumb of affected side. His 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.
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 to find the causative factor and check its further progression. Secondly after few days, rehabilitation therapy helps to minimize disability.
- Several medicines are prescribed to control the primary cause such as anti hypertensive, anti-thrombolytic agents to dissolve the clot, drugs to control cerebral edema etc.
- Intensive physical therapy is begun after few days. Activities such as walking, standing are done repeatedly under the guidance of physiotherapist. It helps to improve the muscular functions which have become rigid. It is aimed to make the patient self sufficient to perform his daily activities.
- Patient is taught to move his affected arm with his strong arm. With exercise it is possible to maintain flexibility of joints and it also prevents tightening and shortening of muscles. Speech therapy is simultaneously begun to improve communication and speaking skills.