Hemiplegia is a condition caused by brain damage or spinal cord injury that leads to paralysis on one side of the body. It causes weakness, problems with muscle control, and muscle stiffness. The degree of hemiplegia symptoms vary depending on the location and extent of the injury.

If hemiplegia onsets before birth, during birth, or within the first 2 years of life, it’s known as congenital hemiplegia. If hemiplegia develops later in life, it’s known as acquired hemiplegia. Hemiplegia is non-progressive. Once the disorder begins, symptoms don’t get worse.

Keep reading to learn about why hemiplegia occurs and the common treatment options available.

Hemiparesis vs. hemiplegia

Hemiparesis and hemiplegia are often used interchangeably and produce similar symptoms.

A person with hemiparesis experiences weakness or a slight paralysis on one side of their body. A person with hemiplegia can experience up to full paralysis on one side of their body and may have trouble speaking or breathing.

Hemiplegia vs. cerebral palsy

Cerebral palsy is a broader term than hemiplegia. It includes a variety of disorders that affect your muscles and movement.

Cerebral palsy develops either before birth or in the first few years of life. Adults can’t develop cerebral palsy, but a person with cerebral palsy might notice symptoms change as they age.

The most common cause of hemiplegia in children is a stroke when they’re in the womb.

Hemiplegia can affect either the left or right side of your body. Whichever side of your brain is affected causes symptoms on the opposite side of your body.

People can have different symptoms from hemiplegia depending on its severity. Symptoms can include:

  • muscle weakness or stiffness on one side
  • muscle spasticity or permanently contracted muscle
  • poor fine motor skills
  • trouble walking
  • poor balance
  • trouble grabbing objects

Children with hemiplegia may also take longer to reach developmental milestones than their peers. They may also use only one hand when playing or keep one hand in a fist.

If hemiplegia is caused by a brain injury, the brain damage can cause symptoms that aren’t specific to hemiplegia, such as:

  • memory problems
  • trouble concentrating
  • speech issues
  • behavior changes
  • seizures

Stroke

Strokes are one of the most common causes of hemiparesis. The severity of muscle weakness that you experience can depend on the size and location of a stroke. Strokes in the womb are the most common cause of hemiplegia in children.

Brain infections

A brain infection can cause permanent damage to the cortex of the brain. Most infections are caused by bacteria, but some infections may also be viral or fungal.

Brain trauma

A sudden impact to your head can cause permanent brain damage. If the trauma only affects one side of your brain, hemiplegia can develop. Common causes of trauma include car collisions, sports injury, and assaults.

Genetics

An extremely rare mutation of the ATP1A3 gene can cause a condition known as alternating hemiplegia in children. It causes temporary hemiplegia symptoms that come and go. This disorder affects about 1 in 1 million people.

Brain tumors

Brain tumors can lead to a variety of physical problems including hemiplegia. Symptoms of hemiplegia may get worse as the tumor grows.

The following are movement disorders that can cause hemiplegia symptoms.

Facial hemiplegia

People with facial hemiplegia experience paralyzed muscles on one side of their face. Facial hemiplegia may also be coupled with a slight hemiplegia elsewhere in the body.

Spinal hemiplegia

Spinal hemiplegia is also referred to as Brown-Sequard syndrome. It involves damage on one side of the spinal cord that results in paralysis on the same side of the body as the injury. It also causes loss of pain and temperature sensation on the opposite side of the body.

Contralateral hemiplegia

This refers to paralysis on the opposite side of the body that brain damage occurs in.

Spastic hemiplegia

This is a type of cerebral palsy that predominately affects one side of the body. The muscles on the affected side are constantly contracted or spastic.

Alternating hemiplegia of childhood

Alternating hemiplegia of childhood usually affects children younger than 18 months old. It causes recurring episodes of hemiplegia that affect one or both sides of the body.

Treatment options for hemiplegia depend on the cause of the hemiplegia and the severity of symptoms. People with hemiplegia often undergo multidisciplinary rehab involving physical therapists, rehabilitation therapists, and mental health professionals.

Physiotherapy

Working with a physiotherapist allows people with hemiplegia to develop their balance ability, build strength, and coordinate movement. A physiotherapist can also help stretch out tight and spastic muscles.

Modified constraint-induced movement therapy (mCIMT)

Modified constraint-induced movement therapy involves restraining the side of your body unaffected by hemiplegia. This treatment option forces your weaker side to compensate and aims to improve your muscle control and mobility.

One small study published in 2018 concluded that including mCIMT in stroke rehabilitation may be more effective than traditional therapies alone.

Assistive devices

Some physical therapists may recommend the use of a brace, cane, wheelchair, or walker. Using an assistive device may help improve muscular control and mobility.

It’s a good idea to consult a healthcare professional to find which device is best for you. They may also recommend modifications you can make to your home such as raised toilet seats, ramps, and grab bars.

Mental imagery

Imagining moving the paralyzed half of your body may help activate the parts of the brain responsible for movement. Mental imagery is often paired with other therapies and is rarely used by itself.

One meta-analysis looking at the results of 23 studies found that mental imagery may be an effective treatment option for regaining strength when combined with physical therapy.

Electrical stimulation

A medical professional can help stimulate muscular movement by using electrical pads. The electricity allows muscles that you can’t move consciously to contract. Electrical stimulation aims to reduce imbalances in the affected side of the brain and improve brain plasticity.

Hemiplegia is a permanent condition and there’s no cure at this time. It’s known as a non-progressive disease because the symptoms don’t get worse over time.

A person with hemiplegia who undergoes an effective treatment program may be able to improve the symptoms of their hemiplegia over time. People with hemiplegia can often live independent and active lives with the use mobility aids.

If you have a child with hemiplegia, you can find information and support from the Children’s Hemiplegia and Stroke Association website. You can find specific resources for your state on their website. They also have resources for people based in Canada or the United Kingdom.

If you’re managing hemiplegia caused by a stroke, you can find a long list of resources on the Stroke Center website.

Hemiplegia is a severe paralysis on one side of your body caused by brain damage. It’s a non-progressive disorder and doesn’t get worse once it develops. With a proper treatment plan, it’s possible to improve the symptoms of hemiplegia.

If you’re living with hemiplegia, you can make the following changes to your lifestyle to aid your rehabilitation:

  • Stay active to the best of your ability.
  • Modify your home with assistive devices like ramps, grab bars, and handrails.
  • Wear flat and supportive shoes.
  • Follow your doctor’s recommendation for assistive devices.