Hemiparesis - Types, Treatment, Facts and Information

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Hemiparesis is a condition that is commonly caused by either stroke or cerebral palsy, although it can also be caused by multiple sclerosis, brain tumors, and other diseases of the nervous system or brain.

The word, 'hemi,' means, 'one side, while, 'paresis,' means, 'weakness.' Approximately eighty-percent of people who experience a stroke also have some level of trouble moving one side of their body, or have weakness on one side. Hemiparesis is a condition that is commonly caused by either stroke or cerebral palsy, although it can also be caused by multiple sclerosis, brain tumors, and other diseases of the nervous system or brain. Hemiparesis is related to a condition called,'hemiplagia,' involving paralysis of one side of a person's body, instead of weakness. There are a number of reasons people develop hemiparesis, although the condition most commonly occurs as a secondary complication of another medical issue. The treatment options for hemiparesis differ depending on the reason why a person has developed the condition.

Causes

Brain damage caused by head injuries, cancerous growths in a person's brain, or disease may also lead to the development of muscle weakness. Muscle weakness appears in the side of the person's body that corresponds to the area of the brain that has been injured. Damage to the person's spinal cord may include damage caused by trauma, such as injuries received through a fall, a car accident, or a wound received in a fight or combat. Conditions including multiple sclerosis, as well as some forms of cancer, may also cause lesions on a person's spinal cord that interfere with the functioning of their nerves.

The muscle weakness that is characteristic of hemiparesis may be caused by lesions in a person's spinal cord which damages their nerves and innervates their muscles, leading to weakness. Damage to the person's brain can lead to muscle weakness as well. Stroke; however, is the most common reason people develop hemiparesis. At times, muscle weakness is one of the key symptoms of stroke, bringing people to the hospital in the first place.

Diagnosing

When a patient presents with hemiparesis, the first step is to determine the origins of the muscle weakness. Medical imaging studies can be used to isolate the location of the damage, and the patient will also typically be interviewed to collect a medical history for the purpose of identifying obvious risk factors. If a patient says that he or she has multiple sclerosis, for example, the doctor will likely attribute the hemiparesis to this condition and may conduct tests to confirm.

Forms of Hemiparesis

People who experience hemiparesis can have difficulty moving their legs and arms, walking, and might also have a loss of balance. Due to this, performing everyday activities such as dressing, eating, grabbing objects, or using the bathroom can be more difficult. Loss of abilities related to a stroke or hemiparesis depend upon the area of the person's brain that has been damaged.

• Right-sided Hemiparesis:

  Involves injury to the left side of the person's brain. The left side of a person's brain controls speaking and language. People who have this type of hemiparesis can also experience difficulty with talking and understanding what others say, as well as determining left from right.

• Left-sided Hemiparesis:

  Involves injury to the right side of the person's brain, which controls learning processes, certain types of behavior, and non-verbal communication. Injury to this area of a person's brain may also cause people to talk excessively, have short attention spans, as well as memory problems.

• Ataxia:

  Injury to the lower portion of a person's brain may affect their body's ability to coordinate movement. The result is referred to as, 'ataxia,' and might lead to difficulties with walking, balance, and posture.

• Pure Motor Hemiparesis:

  Pure motor hemiparesis is the most common type of hemiparesis. People who experience this type of hemiparesis have weakness in their leg, arm, and face. The condition may affect the person's body parts equally, or it may affect one body part more than others.

• Ataxic Hemiparesis Syndrome:

  Ataxic hemiparesis syndrome involves weakness or clumsiness on one side of a person's body. The person's leg is often more affected than their arm. The symptoms happen over a period of hours to days.

Treatments and Rehabilitation

Rehabilitation can help people with hemiparesis to learn new ways of moving and using their legs and arms. There is potential, with immediate therapy, for people who experience hemiparesis to eventually regain movement. There are a number of professionals involved in rehabilitation for hemiparesis.

• Physiatrists:

  Physiatrists are doctors who specialize in rehabilitation. As with any other diagnosis, people who have experienced a stroke require the care of a health care provider who is familiar with not only established practices, but new treatments. A physiatrist is a person who can help to manage the rehabilitative process of someone who has experienced a stroke.

• Physical Therapists:

  Physical therapists specialize in treating disabilities related to large movement and can help with endurance, strength, and range of motion problems. A physical therapist may also assist with getting a person who has had a stroke the use of their legs and arms back via balance and coordination skills exercises.

• Occupational Therapists:

  Occupational therapists can help people who have experienced a stroke to perform activities of daily living and fine motor skills. They may also assist people to learn how to change their environment with the intention of meeting the person's new needs.

  Medical science has created, or is looking into, some promising new treatments for people with hemiparesis that can also help people who have experienced a stroke to improve movement in their legs and arms after the initial stroke.

• Electrical Stimulation:

  Electrical stimulation is something that has been used in the treatment of hemiparesis to strengthen the person's arm while improving their range of motion. The procedure involves placement of small electrical pads on the muscles of the person's weakened arm and applying a small electrical charge to help their muscles contract as the person works to make it move. A number of these electrical stimulation devices are now covered through insurance and may be used in a person's own home.

• Cortical Stimulation:

  Researchers are examining cortical stimulation, something that involves electrical stimulation to the area of the person's brain called the, 'cortex,' to find out if it can improve the person's arm and hand movement. The procedure is performed by placing a tiny electrode on the membrane covering the person's brain. The electrode sends a tiny electrical current to the person's brain while the person performs rehabilitation exercises. At this time, the therapy is only targeted toward people who have some level of movement in their wrist and fingers.

• Botox/Baclofen:

  A number of studies have demonstrated that certain treatments may be helpful in relaxing the muscles in people who have tone, or spasticity. The condition involves a certain body part on the affected side that is difficult to move, where the person feels as if they are tightened up. Treatment with injection of Botox, and the use of Baclofen, may improve the condition.

• Motor Imagery (MI):

  When a person imagines themselves using a specific part of their body, areas of their brain and muscles can be activated as if the person is really doing the activity they are imagining. Mental practice, at times referred to as, 'Motor Imagery,' or MI, helps people to visualize or imagine their limbs moving. The practice can improve the arm movement of people with hemiparesis, and it has been suggested that MI can be used to help people to walk.

• Modified Constraint-induced Therapy (mCIT):

  mCIT is a form of treatment involving people with hemiparetic arms who visit a therapist three times per week for a half hour throughout a ten-week period of time. Through that time, as well as at home for a number of hours each day, the person practices focused exercises using their weak arm. Research studies have demonstrated that modified CIT increased both the movement and use of the person's arm. Modified CIT; however, only works for people who have some level of movement remaining in their wrists and fingers.

Treatment of hemiparesis may include treatment of the person's underlying condition with the goal of resolving the hemiparesis, or ending its progress entirely. Physical therapy is an important part of the person's treatment. Therapy assists people to regain control of their muscles while developing muscle strength. Physical therapists might also give a person adaptive tricks and tips that can help them to navigate a world that has been created for people who have full muscle strength in both sides of their body. Assistive devices to include walkers, braces, and wheelchairs may also be helpful to people who have difficulties with walking as a result of hemiparesis.

Author Credentials:

Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a Nursing Assistant Thomas has assisted people from a variety of racial, religious, gender, class, and age groups by providing care for people with all forms of disabilities from Multiple Sclerosis to Parkinson's; para and quadriplegia to Spina Bifida.

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