Hemiplegia

What is Hemiplegia?

Hemiplegia in infants and children is a type of Cerebral Palsy that results from damage to the part (hemisphere) of the brain that controls muscle movements. This damage may occur before, during or shortly after birth.

The term hemiplegia means that the paralysis is on one vertical half of the body. A similar medical term, hemiparesis, means a weakness on one side of the body. In children with hemiplegia, the paralysis in the body occurs on the side opposite the affected part of the brain. For example, if the left side of the child’s brain is injured, then the paralysis will be on the right side of the child’s body.

What are the Symptoms Of Hemiplegia in a Child?

The symptoms of spastic hemiplegic cerebral palsy may differ from child to child and over time. Symptoms may include:

stiffness and weakness in muscles on one side of the body
only using one hand during play or favoring one hand before the age of 3 years
keeping one hand in a fist
difficulty with walking and balance
difficulty with fine motor tasks like writing or using scissors
delay in reaching expected developmental milestones such as rolling over, sitting up, crawling, or smiling

What are some of the Conditions Related to Hemiplegia in a Child?

Hemiplegia is often the result of a brain injury. A wide range of physical, cognitive, and behavioral effects can result from a brain injury. Each child is different and your child may or may not have some of the following effects of the brain injury:

Memory – Difficulty with encoding, storing, and retrieving new information.
Attention and Concentration – Problems focusing and sustaining attention for along periods of time. She may be unable to filter out distractions in the classroom or may have problems functioning in situations where there is a great deal of noice or stimluation. The child may have difficult switching from one topic or activity to another.
Executive Functions – Difficulty setting appropriate goals, planning and organizing behavior to accomplish tasks, and monitoring and evaluating behavior.
Speech and Language – Depending on the age and cause of injury, the child may have problems with speech, such as lack of speech or extremely slow speech. These may improve with time. Children who have a focal injury(stroke) at or near birth, may have delays in expressive language (talking), but not in receptive language (understanding). These children often begin to catch up with peers by age 3 or so.
Social Communiation – The ability to participate in conversation with others requires the use of cognitive, linguistic, and social skills, all of which can be affected by an early brain injury. The child may have difficulty following shifting topics, interpretation of social cues, organization of ideas, and application of rules of social behavior.
Behavior – May experience agitation, irritability, mood swings, hyperactivity, apathy and emotional and behavioral outbursts as a result of the brain injury. The psychosocial problems can be extremely complex.
Sensory Effects – Difficulty with vision and impaired coordination of both eyes. The brain’s visual processing area may be injured, resulting in visual field cuts (partial losses of vision). Hearing may also be affected.
Seizures – May develop immediately following the injury or months or even years later. In many cases, the seizures can be controlled through medication.

See the Medical section of the CHASA website for additional information.

Is Hemiplegia a Progressive Condition?

Baby with a cast No hemiplegia is not a progressive condition, nor is it a disease. As children experience growth spurts, they may have more problems with muscle spasticity, but this does not mean that the initial injury has gotten worse.

Children with hemiplegia tend to show some atrophy of the hand, arm, shoulder, leg, and foot. This appears more noticeable as the child reaches his or her teens. The child’s arm and leg on the affected side are often shorter than the other side. Some of this may be a true difference in the length of the bone. The limb may also “appear” shorter, but this appearance is not a true length difference and is actually due to the increased muscle tone pulling the limb upwards. Weight bearing and strengthening exercies may help prevent atrophy and increase use.

Children with hemiplegia are at a higher risk of developing scoliosis. It is recommended that your child be followed by an orthopedic surgeon or physiatrist so they can watch for signs of scoliosis and treat if necessary.

Are There Treatments For Children With Hemiplegia?

Children with hemiplegia cannot be “cured”, but therapies can help with some of the symptoms. Medication can be prescribed for seizures. Orthotics, braces, and splints may help with spasticity and gait (walking). See the Treatment section of the CHASA website for more information.

For more detailed information, read Hemiplegia in Children by John Lynch, DO, NINDS

Will my Child with Hemiplegia be in a Special Education Program at School?

Most children with hemiplegia attend traditional schools and are integrated into a traditional classroom. Some children may be pulled out of class or have a special teacher who comes into class to help with challenging subjects. Other children may be in smaller non-integrated classrooms if those better fit their needs. See the School section of the CHASA website for more information.