Pediatric hemiplegia

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Pediatric hemiplegia is a surprising and frustrating disease and ever hard to tell the parents about.

What is hemiplegia?

A rare disease and is diagnosed before the age of 4 years. It involves paralysis of a vertical half of the body so affects upper and lower limb and half of face because of brain injury during pregnancy or at the delivery time.

Usually, the mother goes through normal pregnancy and delivery, and the case is not noticed until the baby is about 1 year old, or few months earlier.  

Congenital hemiplegia affects male more than female babies

It happens because of brain injury in the opposite cerebral hemisphere

Pediatric hemiplegia

Causes of pediatric hemiplegia

    • Infections in the central nervous system: (e.g. meningitis, encephalitis and brain abscess)
    • Cerebral palsy and its several causes
    • Bleeding inside the brain and its ventricles
    • Intracranial tumor: mass in the brain substance so it may compress the motor area
    • Central nervous system trauma
    • Perinatal hypoxia: deficiency of oxygen supply to the brain of the baby
    • Sickle cell anemia and some blood disease
    • Venous thrombosis
    • Inflammation of blood vessels of the brain
    • Abnormal development of the brain
Cerebral palsy

Signs and symptoms of pediatric hemiplegia

  • Hemiplegia means paresis (weakness) or paralysis of one half of the body including the face, with the upper limb affected more than the lower limb. The elbow is flexed at the and closed fist.
  • Muscle pain
  • The baby uses only one hand all the time to eat, play and catch
  • Delayed motor development such as delayed head support and delayed walking
  • Difficult in walking and maintaining the balance

Associated signs and symptoms

  • Epileptic convulsions: focal convulsions are the most common seen with pediatric hemiplegia, but it can be associated with generalized convulsions.
  • Behavioral abnormalities and Agitation
  • Autism and attention deficit syndrome
  • Abnormal speech and hyperactivity
  • Visual and hearing problems
  • Narrow range of movements and easy fatigue
  • Depression and apathy
  • Muscle weakness and difficult movements

Management and rehabilitation of pediatric hemiplegia

It is prolonged and shows slow progress so needs cooperation between doctors and parents but have promising results

Physiotherapy

Exercises for muscle stretching and range of motion exercise

Management of pediatric hemiplegia

Applying short electrical currents to the affected muscle so reduce its spasm

Gait training: through training of the child on equal weight distribution on lower limbs, heel strike and weight shifting

Hydrotherapy: Doing exercises in warm swimming pool so relax his muscles

Splinting

Use special shoes and splints so straighten the affected limbs

Positioning in bed

Lay him on the affected side, and support his body by pillows from frontal and back aspects and then bend the other leg and support its knee by pillows.

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