HEMIPLEGIA ( ONE SIDED PARALYSIS)

Many conditions give rise to hemiplegia. Generally, an injury to the right side of the brain will cause a left-sided hemiplegia while an injury to the left side of the brain will cause a right-sided hemiplegia.

• Stroke is the commonest cause of hemiplegia. Insufficient blood supply to the brain leads to loss of brain functions. The stroke may be caused by:
  • A clot formed within the blood vessel blocking the blood supply’-> a thrombus
  • A thrombus breaks away from its site of origin and forms a block elsewhere in the circulation. -> an embolus
  • A bleed from a blood vessel supplying the brain -> a hemorrhage
• Head injury
• Diabetes
• Brain tumor
• Infections -> meningitis, encephalitis
• Migraine syndrome -> recurrent headaches of severe intensity occasionally accompanied by sensations of numbness and tingling in one half of the body.
• Inflammation of the blood vessels -> vasculitis
• Diseases affecting the nerves -> like Multiple Sclerosis; acute necrotizing myelitis.
• Conditions presenting from birth -> cerebral palsy. Lack of blood supply damages nerve cells in the brain. Birth trauma, difficult labor, perinatal strokes in infants within 3 days of birth can all cause cerebral palsy.
• Hereditary diseases -> leukodystrophies. This is a rare disorder affecting the myelin sheath which covers and protects nerve cells in the brain. The condition usually appears in infancy or childhood.

Injury or insults to the brain cells that control movements in one half of the body cause hemiplegia. Hence, symptoms largely depend upon the part of the brain affected. The same can be said about the severity of individual symptoms.

• Difficulty in walking.
• Problems in balance, losses balance when trying to walk
• Difficulty in swallowing
• The trouble with vision. Blurred vision or weakness of the eyes.
• Speech becomes difficult.
• Numbness, tingling or loss of sensations in one half of the body.
• Loss of control over bladder and bowel movements leading to an inability to hold on to stool or urine.
• Unable to perform tasks like holding objects, tying laces, dressing oneself, buttoning etc.
• Feeling depressed
• Heightened emotional sensitivity with the inability to handle stressful situations.
• Memory seems poor. Unable to recall recent or past events concerning people, places, and activities.

The presentation will also depend on which side of the brain is damaged.

• Right hemiplegia is caused by damages n the left hemisphere while with left hemiplegia it is vice versa.
• Right hemiplegia most often shows -> loss of sensations on the left side. There will be difficulty in understanding the spoken or written word -> condition called aphasia.
• Left hemiplegia often presents itself after right cerebral hemisphere damage. It usually presents with
  • Loss of control over purposeful movements.
  • Unable to use objects correctly.
  • Unable to draw, comb hair or cook.

Conditions like Alternating Hemiplegia have recurring episodes of hemiplegia. But, attacks are generally preceded by warning symptoms like –

• Yawning
• Fatigue
• Appearing very exhausted

Pure hemiplegia has to be differentiated with Alternating Hemiplegia that affects children. Though relatively rare, this condition has recurring episodes of weakness in one half of the body alternating with periods when there are no weaknesses. During an attack, the child may suffer from the many symptoms of a stroke. They may develop long-term sequelae like movement disorders and behavior problems.

Doctors may want a few procedures done to find the cause of hemiplegia. Some required tests are:

• Complete blood count.
• Blood biochemistry test.
• Cranial CT -> a highly detailed, non-invasive, imaging procedure that combines x-rays with computer technology and allows the study of the brain from many angles.
• Cranial MRI -> a non-invasive, highly sensitive procedure that uses electromagnetic properties of tissues providing detailed studies of their structures.
• An EEG (electroencephalogram) -> can measure the nerve activity within the brain.

Hemiplegia usually takes awhile to recover. There are two facets in treating the condition.

• Check further progress of underlying condition
• Rehabilitation and control of disability.

Hemiplegia is often non-progressive and many available measures make coping with it less stressful to the person affected as well as caregivers.

• Neuromuscular Electrical Stimulation (NMES)
  High-intensity electrical stimulation is a proven way to maintain size – and even function – in muscles which must temporarily take a complete break from activity.
  The right kinds of electrical stimulation can keep muscles relatively sound, even when they are not being stimulated by the nerves or engaging in any real activity.
• Botulinum Toxin Injections
  Some forms of hemiplegia make the limb muscles very taut and resistant even to passive movements. Botulinum injections decrease the high muscle tone of these muscles. However, it is only a temporary and expensive solution to a chronic condition.
• Intensive physiotherapy sessions
  Activities like standing, walking are done repetitively under the guidance of trainers to prevent muscle degeneration from prolonged under use.
• In Alternating Hemiplegia, the child may require admission in the intensive care unit (ICU) especially if there are any respiratory infections or breathlessness. Low doses of ibuprofen (pain-killer) will help in minimizing the muscle pains after an acute attack. Sound sleep is known to decrease the severity of the attacks. Hence, one must ensure that the child gets sufficient amount of sleep.

Homeopathy provides supportive treatment and prevents any further deterioration. Nonprogressive hemiplegia, in particular, responds well to homeopathic treatment. homeopathic medicines can prevent the paralytic muscles from further degeneration. The medicines act at the level of the nervous system and facilitate proper conduction of signal impulses from the nerves to the muscles. Moreover, homeopathy acts without any side effects and is an excellent adjunct to the available physiotherapy measures.