Hemiplegia

Overview, Causes, & Risk Factors

Hemiplegia is a condition in which there is paralysis on one side of the body. This paralysis may affect part of the body, such as one arm or leg, or the whole side of the body.

What is going on in the body?

Hemiplegia occurs when there is a disruption of blood flow to the brain. This causes part of the brain to die. Messages that usually tell the body when and how to function are interrupted. Paralysis in the body occurs in the side opposite of the affected part of the brain. For instance, if the right side of the brain is affected, the left side of the body becomes paralyzed.

A few types of hemiplegia include:

  • capsular, which is caused from an lesion on part of the internal capsule of the brain
  • cerebral, which is caused by a brain lesion
  • facial, which is paralysis on one side of the face
  • spastic, which is paralysis and spastic or stiff, unusual movements of the body, occurring more often in infants
  • spinal, which is associated with lesions on the spine

    • What are the causes and risks of the condition?

    Hemiplegia is caused by a disruption in the blood flow to part of the brain. This may be due to a stroke, a brain tumor, or excessive bleeding from a head injury.

    A person with diabetes, high blood pressure, or high cholesterol is more at risk for a stroke. Other factors that increase the risk of a stroke include obesity, smoking, leading a sedentary lifestyle, and drinking alcohol.

    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Symptoms with hemiplegia will depend on which side of the brain is affected. They may include:

  • difficulty speaking and/or or understanding words, which is known as aphasia
  • difficulty swallowing
  • difficulty walking
  • problems with balance, known as ataxia
  • difficulty using arms to dress, feed self, or perform other tasks
  • visual impairments, including blurred vision
  • urinary incontinence, the inability to control urination, or bowel incontinence, the inability to hold stool
  • decreased sensation, numbness, or tingling on affected side of the body
  • memory loss
  • difficulty dealing with frustrations
  • depression

    • Diagnosis & Tests

    How is the condition diagnosed?

    The healthcare provider will do a complete medical history and physical exam. He or she may order a number of tests, including:

  • blood tests
  • a cranial CT scan and cranial MRI
  • an electrocephalogram, or EEG, to measure the activity of the brain

    • Prevention & Expectations

    What can be done to prevent the condition?

    Prevention of hemiplegia is related to the underlying cause. Practicing a healthy lifestyle, such as losing weight if needed, drinking less alcohol, not smoking, and exercising, may also decrease the risk of hemiplegia. Following sports safety guidelines for children, adolescents, and adults can decrease the risk of hemiplegia due to injury.

    What are the long-term effects of the condition?

    Long-term effects of hemiplegia will depend on the cause and extent of the paralysis. The person may need extended care in a nursing home or rehabilitation unit. Muscle deterioration may take place. Injuries may also occur from decreased feeling and decreased control over movement.

    What are the risks to others?

    Hemiplegia is not contagious, and poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment is directed at the underlying cause of the paralysis, such as high blood pressure, high cholesterol, and diabetes. Anticoagulants or blood thinners may be used to treat blood clots. In some cases, surgery may be needed to remove a tumor or bleeding around the brain.

    The goal of treatment is to help a person reach his or her fullest potential for independence and functioning. This may involve physical therapy, occupational therapy, and speech therapy. Learning or relearning how to care for oneself, speak, and write may be part of therapy. The potential for recovery depends on the extent of the paralysis.

    What are the side effects of the treatments?

    Side effects will depend on the treatment used. Medications can cause many side effects including stomach upset, rash, or allergic reactions. Surgery may pose a risk of bleeding, infection, or allergic reaction to anesthesia.

    What happens after treatment for the condition?

    Treatment may never end, depending on the extent of the hemiplegia and its underlying cause. Careful monitoring, following through with therapy and treatment, and seeking medical help as needed is the best way to help the person be as independent as possible.

    How is the condition monitored?

    Any new or unusual symptoms should be reported to the healthcare provider.

    Attribution

    Author:Eileen McLaughlin, RN, BSN
    Date Written:
    Editor:Smith, Elizabeth, BA
    Edit Date:09/18/00
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:07/03/01

    Sources

    www.ninds.nih.gov/health_and_medical/pubs/stroke_rehabilitation.htm

    Taber's cylcopedic Medical Dictionary, F.A. Davis, 1993

    Harrison's Principles of Internal Medicine, Fauci, 1998