Spastic hemiplegia is a type of spastic cerebral palsy, where the part of the brain controlling movement is damaged.
The condition can affect children before birth, during labor, or in the first few years of their lives. This type of hemiplegia makes it difficult for the child to do simple tasks, such as picking up an object or walking.
Some children with spastic hemiplegia may also develop other disorders, such as epilepsy and attention deficit hyperactivity disorder (ADHD).
In general, hemiplegia is a type of unilateral cerebral palsy that causes paralysis on only one side of the body. It's due to an injury to the spinal cord or the brain. The common signs of hemiplegia are poor muscle control, muscle stiffness, and weakness.
The severity of the symptoms depends on the condition causing hemiplegia.
What Causes Spastic Hemiplegia?
Cerebral palsy/CP is the general term for movement disorders that affect a child during development. The leading cause of cerebral palsy is an injury to the brain. The resulting condition differs based on the part of the brain that was injured.
In most cases, there's an injury to the pyramidal tracts or the motor cortex in the brain.
Motor cortex. The motor cortex is in the cerebral cortex of the brain. The largest part of the brain, the cerebral cortex, has many sub-parts that send signals to each other. Their primary function is to control movement.
When there's damage to the motor cortex, voluntary movement is affected. Thus, people with spastic hemiplegia have trouble controlling movements.
Pyramidal tracts. These tracts allow communication between the spinal cord and the cerebral cortex. When they are damaged, this communication stops. As a result, certain essential functions, such as touch and movement, are affected.
The following factors can damage both these parts of the brain:
- Prenatal (before birth) infection or brain hemorrhage
- Brain trauma at the time of birth
- Brain infection at birth
- Lack of oxygen supply to the brain at birth
What Are the Symptoms of Spastic Hemplegia/Cerebral Palsy?
The main symptom of spastic hemiplegia is paralysis on one side of the body. Some other symptoms are:
- Tight muscles
- Muscle stiffness on one side
- Difficulty with tasks that involve the hands
- Exaggerated body movements
- Joints that don't extend fully
- Walking on tiptoes
- Poor reflexes
- Crossed knees
Besides these symptoms, the child may have other problems, such as vision loss and hearing impairments. However, these are not due to cerebral palsy. Instead, some birth injury, such as hypoxic-ischemic encephalopathy (a condition in which the brain does not get enough oxygen), causes these issues.
Recognizing the signs of spastic hemiplegia can be difficult during the child's first year. Many children only start showing symptoms when they begin to miss milestones in development, such as crawling or walking.
What Is the Treatment for Cerebral Palsy?
The best cerebral palsy treatment option for a child depends on their symptoms and the secondary conditions resulting from hemiplegia. Here are some options your doctor may give you:
- Physical therapy. Doctors recommend physical therapy to make the child as independent as possible in terms of movement. This therapy focuses on stretching the child's stiff muscles and making them more flexible.
- Occupational therapy. OT helps the child perform daily tasks independently at school or home. Occupational therapists focus on wrist muscles, forearms, and the child's upper body movements. Therapists can also determine if the child might need assistive devices, like writing utensils and specialized scissors.
- Speech therapy. Children with spastic hemiplegia may drool or have difficulty speaking. Speech therapy includes exercises that strengthen the speech muscles and improve coordination. Along with speaking, a child's chewing, swallowing, and breathing also gets better with speech therapy.
- Medication. Doctors also prescribe medications to reduce muscle stiffness and make body movements easier. Some specific medications can also relieve stiffness in certain body parts, like arms and legs. If the child also has seizures, the doctor will prescribe medicines to lower the frequency of seizures.
- Surgery. Some children with spastic hemiplegia may have dislocated joints or short muscles. Surgery can help correct malformations that are affecting the child's ability to move properly. The most common surgery for children with spastic cerebral palsy is selective dorsal rhizotomy. It relaxes the muscles, reducing their stiffness and improving movement.
Some children with spastic hemiplegia may not show symptoms for a few early years of their lives. If you notice muscle stiffness or your child has missed developmental milestones, speak to your doctor. An early diagnosis can help improve your child's movement and make them more independent.