Spastic Hemiplegia

Spastic Hemiplegia is a neurological disorder that results in the muscles on one side of the body being in a constant contracted state. This neurological dysfunction occurs in patients with Cerebral Palsy. About 20–30% of patients who suffer from Cerebral Palsy are suffering from spastic hemiplegia. Due to brain or nerve damage, the brain is constantly sending action potentials to the neuromuscular junctions on the effected side of the body. Similar to strokes, damage on the left side of the brain affects the right side of the body and damage on the right side of the brain affects the left side of the body. The effected side of the body is rigid, weak and has low functional abilities. In most cases, the upper extremity is much more affected than the lower extremity. This could be due to preference of hand usage during early development. If both arms are affected, the condition is referred to as double hemiplegia. Some patients with Spastic Hemiplegia only suffer minor impairments, where in severe cases one side of the body could be completely paralyzed . The severity of spastic hemiplegia is dependent upon the degree of the brain or nerve damage.

Causes

There are many different brain dysfunctions that can account for the cause for Spastic Hemiplegia. Spastic Hemiplegia occurs either at birth or in the womb. The cause can be all types of strokes, head injuries, hereditary diseases, brain injuries and infections. Malformations of the veins or arteries in any part of the body can lead to Spastic Hemiplegia. The artery most commonly affected is the middle cerebral artery. Unborn and newborn babies are susceptible to strokes. Leukodystorphies are a group of hereditary diseases that are known to cause Spastic Hemiplegia. Brain infections that cause Spastic Hemiplegia are meningitis, multiple sclerosis, and encephalitis.

Complications

The muscles spasticity causes gait patterns to be awkward and jerky. The constant spastic state of the muscle can lead to bone and tendon deformation, further complicating the patient’s mobility. Many patients with spastic hemiplegia are subjected to canes, walkers and even wheel chairs. Due to the decrease in weight bearing, patients are at a higher risk of developing osteoporosis. An unhealthy weight can further complicate mobility. Patients with spastic hemiplegia are a high risk for experiencing seizures. Oromotor dysfunction puts patients at risk for aspiration pneumonia. Visual field deficits can cause impaired two-point discrimination. Many patients experience the loss of sensation in the arms and legs on the affected side of the body. Nutrition is essential for the proper growth and development for a child with spastic hemiplegia</ref>

Treatment and Physical Therapy

Physical therapy is the standard treatment for Cerebral Palsy. Therapy focuses on the prevention of muscle stiffening and increasing muscle strength. Pharmacotherapy is used to treat seizures and to induce muscle relaxation. Braces can be used to correct deformities. Surgery is sometimes needed to correct extreme deformations.

References

• Abdel-Hamid, Hoda, Ari Zeldon, Alicia Bazzano, Amy Kao, Boosara Ratanawongsa, and Francisco Talavera. "Cerebral Palsy A Clinical Presentation." *Medscape. N.p., 12/9/11. Web. 8 Feb 2012.
• Brashear, Allison (2010).Spasticity: Diagnosis and Management.New York: Demos Medical Publishing.
• Green, L.B., & Hurvitz, E.A. (2007). Cerebral Palsy. Physical Medicine and Rehabilitation Clinics of North America, 18(4), pp.859–882, vii.
• LaAbdel-Hamidst, H.. Cerebral palsy. N.p., 2011. Web. 8 Feb 2012. http://emedicine.medscape.com/article/1179555-overview
• Tardieu, C., &Tardieu, G. (1987). Muscle hypoextensibility in children with cerebral palsy. Archives of Physical Medicine and Rehabilitation, 8, 63–67.