Forms of Cerebral Palsy: Hemiplegia

The most common form of motor dysfunction in hemiplegia is spasticity and the resulting decreased growth of the affected muscles. As with other forms of CP, the shortened muscles cause progressively, less range of movement and increased stiffness in the joints of the limbs involved.

Because of the natural variation in development, mild abnormalities are often unnoticed by both parents and pediatricians. One symptom that can be an early clue is early hand preference. Hand preference, left or right is usually not established until 18-24 months of age in infants without some form of motor impairment. If the young infant consistently favors one hand over the other even if the toy or object is presented to the other hand, it may be due to hemiplegic. The involved hand may often be held in a fist and the leg on the involved side of the body may seem weaker than the other.

As the child reaches the normal age range for sitting, they too will sit up but may often fall to the side affected by cerebral palsy. As they grow stronger, children with classic hemiplegia will be able to hold themselves up and become capable sitters.

After a child is diagnosed with hemiplegia, a full neurological evaluation is necessary to discern if other conditions are present and to make sure no other condition, such as a brain tumor, is causing the child’s symptoms. Parents can then begin a process, which continues throughout the coming years, of consulting with health care professionals (physicians, occupational and physical therapists) and teachers to develop a level of expectation and a plan which is consistent with the individual child’s abilities.

As the child grows evaluations will take place to see if any special braces or splints would aid the involved limb giving The child better use of both hands. During play in early childhood the child should be given toys and other playthings that promote the use of two-handed manipulation and which encourage both hands working together. It is important not to force the child to do something she is not physically able to do or push her to the point of frustration.

A child with hemiplegia may start walking late and may first start walking on tiptoe. They also may grow out of this. If not, there are special braces and devices which can help to normalize the foot position. It is unusual except in the most severe forms of hemiplegic cerebral palsy for the child to be unable to walk.

The majority of children with hemiplegia have normal intelligence, go to regular, age-appropriate schools, can expect to have relatively normal function as adults, and have few problems beyond the physical difficulties of the arm and leg that are involved.