Hemiparesis left-sided and right-sided: what is it?

What is hemiparesis, and how to cure this disease?

Very often patients are diagnosed with hemiparesis. What it is? This disease, which can provoke partial paralysis of the muscle tissue of the body and face.

There is a pathology as a result of local damage to the cerebral cortex, sometimes even because of spinal cord injury. In this case, the patient loses sensitivity of any side of the body. There are several types.

Develops hemiparesis at different ages, but most cases suffer from this pathology, either children or the elderly.

It is accompanied by severe symptoms and is amenable to complex therapy. Preliminary thorough examination.

Causes of development

In order for the treatment to be effective, it is worthwhile correctly establishing the cause of the development of this pathology. The provoking factors of paralysis can be such deviations as:

1. Stroke. It is considered the most common cause of hemiparesis, since this disease can provoke a rupture of blood vessels and the separation of the blood clot from the wall. Therefore, after a stroke, it is recommended to be constantly under the supervision of a specialist and under the first manifestations of deterioration to undergo a complete examination.
2. Volumetric neoplasm, which occurred after a stroke or began to increase because of it. The tumor, which is constantly increasing in size, can damage healthy cells of the brain and provoke a disruption in its performance. This occurs as a result of excessive pressure on the brain areas.
3. Slowly flowing oncology. Very often, together with cancer, hemiparesis is diagnosed.
4. Injury of the craniocerebral box, which led to a concussion of the brain, a severe bruise and the death of a large part of the cells.
5. Encephalitis. It occurs as a result of the development of infectious, allergic and toxic factors.
6. After epileptic condition. If after a regular attack the patient has spasms, this can disrupt the normal functioning of the brain.
7. Migraine. This pathology in most cases has a hereditary nature.
8. Deviations resulting from the progression of diabetes mellitus. This can be explained by the fact that this disease of the endocrine system can lead to convulsions in the brain.
9. Multiple sclerosis. This pathology destroys the protective envelopes of the nerve and damages the nerve itself.
10. Atrophic processes in the cortex, which provoke the gradual withering away of brain neurons.
11. Congenital hemiparesis and cerebral palsy.

Apparently, there are many provocative causes of hemiparesis.

To exclude various complications, it is necessary as soon as possible to seek professional help, eliminate the factor-provoker and undergo treatment. Refer to a specialist immediately after the first signs of deviation.

Types and complications of the disease

Depending on the lesion of the hemisphere of the brain, left-sided and right-sided hemiparesis are isolated.

To understand the consequences of this or that violation, it is necessary to know what each hemisphere is responsible for.

The left part of the brain is responsible for speech, logic, analysis, numerical calculations and linear representations. The right part of the brain is responsible for perception of the surrounding world, imagination, dreaming, rhythm and color perception.

Right-sided hemiparesis in most cases is diagnosed in patients of the older age group as a result of diseases or trauma to the left side of the brain, spinal cord.

If the patient is adequately thinking, can talk, but there are violations of muscle activity, then this indicates minor lesions or the pinched nerve endings.

Such a deviation can be eliminated with the help of complex therapy, the main thing is to correctly determine the provoking cause.

In most cases, there is a left-sided hemiparesis in children.

This type of disorder can be provoked by abnormalities in the development of the brain, trauma from childhood, during childbirth, or due to improper care of the baby in the first months after birth.

Left-sided hemiparesis is also diagnosed with neoplasms or jams of nerve endings. In this form, a violation of the speech function, a measure, is diagnosed.

With left-sided and right-sided hemiparesis, there are problems with the operability of the upper and lower extremities. In this case, the affected leg may not bend well, and the hand, on the contrary, can be unbent. If the process affects the same-named limbs, then spasmodic hemiparesis develops.

To determine which part of the brain affected the lesion, it is possible by such pronounced symptoms as: memory impairment, mental efficiency, violation of purposeful movements, recognition of objects or phenomena, speech function and sensitivity, epilepsy. If the lesion of the posterior part of the brain and other areas is diagnosed, the disturbances will mainly affect the upper and lower limbs, as well as the muscular structure of the face.

When hemiparesis, patients often complain of symptoms such as:

1. Prolonged and intensive cephalalgia. Depending on the localization of the head will depend on the form of pathology.
2. Fever, worsening of general health, weakness, increased fatigue, pain in the joints.

Severity of symptoms will depend on the age category of the patient. But, in diagnosing it is worth considering and the fact that the disease can be congenital. In boys after birth, hemiparesis manifests itself immediately and therefore it is immediately worth starting to treat.

This ailment can be determined by a thorough examination. The specialist pays special attention to the affected limbs, assesses the movements. In order for the therapy to be effective it is worthwhile to establish the provoking factor, so the patient is given additional examinations:

1. CT scan.
2. Magnetic resonance imaging.
3. Electromyography.

If the child is sick, the diagnosis is carried out urgently to conduct immediate therapy and eliminate possible complications, as well as to increase the percentage of recovery.

Therapeutic tactics

Therapy will depend on many factors, including the cause of the onset of the disease and the age category of the patient.Treatment is complex.

It is recommended not only to take drugs, but also to carry out strengthening measures. Treatment is selected for each patient individually, depending on the stage of development.

Hemiparesis therapy necessarily includes such activities:

• swimming pool;
• massage and exercise therapy;
• drug therapy;
• hardening and others.

Preparations should be taken only in serious condition. Medication therapy involves the use of funds from the muscle relaxants. Also, during the treatment should take vitamin complexes that contain vitamins B and vitamin E.

In the left-sided kind of pathology, medicines such as: Baksosan, Baclofen, Midokalm, Seduxen, Sibazol, Cerebrolysin and others can prescribe.

Dosage and course of admission is determined by a specialist, taking into account contraindications.

At the first side manifestations from the use of funds, it's worthwhile to immediately seek help, but not to make independent decisions.

Therapeutic physical culture can be carried out both in the home and in rehabilitation centers. Classes should be daily. Also with hemiparesis, hydromassage, physiotherapy massage, and also with the use of mud are useful.

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Patients are advised to pump the press, jump, develop fine motor skills, conduct muscle warming in the area of ​​the diseased part of the body, which will contribute to improved blood flow.

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You can pay attention to Scandinavian walking or riding.

In any situation, the patient should have only a positive attitude and desire to engage.

If he adheres to all the recommendations of a specialist, then the positive result will not take long wait, because hemiparesis is a serious pathology that can lead to negative consequences and complications.

A source: http://SpinaZdorov.ru/neurology/parezy/gemiparez-chto-eto-takoe.html

Symptoms and treatment of left-sided hemiparesis

Left-sided hemiparesis in children is considered a form of infantile cerebral palsy.This pathological phenomenon is accompanied by paralysis of one side of the trunk (in our case, the left one) and occurs against the background of the defeat of motoneurons of the cerebral cortex.

What factors can influence the development of hemiparesis in children and adults? What symptoms accompany the disease and how to treat it? These and other issues will be highlighted in the article.

Congenital and acquired causes

What is hemiparesis, found out. Such an ailment can not only be left-sided.

So, hemiparesis right-sided, upper and lower (defeat of one limb) can be diagnosed.

The extremities of the same name (or only the hands, or only the legs) can be involved in the lesion, which is called spastic hemiparesis, or central hemiparesis.

In spite of what kind of ailment (left-sided, right-sided or central), the reasons contributing to its occurrence are identical. These include congenital and acquired factors:

• presence of a trunk, intracerebral, intracerebral tumor;
• presence of an intracerebral hematoma;
• The existing hygroma, which is the result of trauma;
• the course of the disease (stroke, infarction, acute ischemia);
• if there was a nerchiform haemorrhage;
• thrombosis of the carotid artery;
• if the body has multiple sclerosis or hemiplegic migraine.

Hemiparesis in a child, as a rule, is a congenital disease that occurs against the background of brain pathologies, developing during the prenatal period, in the process of childbirth, after trauma, which entailed a pinch root of the nerve. Most often children have left-sided hemiparesis. Right-sided hemiparesis is diagnosed mainly in adults.

How to recognize the ailment?

Symptomatics with left-sided hemiparesis can differ in this or that case, depending on which part of the brain has caused a pathogenic factor.

For example, when the front part of the cerebral cortex has been affected, the child is diagnosed with mental retardation and in some cases with a severe degree.

Often emotional background suffers, and epileptic seizures also occur.

When the inner capsule of the variolium bridge is affected, the left arm and leg are involved in the ailment.

Very rarely, the facial muscles are affected, in which case mimic disorders occur.

It is worth noting that motor disorders and reduced muscle strength are not the only symptoms that accompany left-sided hemiparesis. Other signs of pathology are:

• headache;
• malaise, which occurs even after a short load;
• the child becomes irritable, there are neuropsychic disorders that are present on an ongoing basis;
• the child becomes difficult to move because of the pain in the joints of the limb (such a symptom is mistaken for the development of arthritis);
• the violation of the gait is characterized by the instability of the left limb;
• the inability to withstand the weight of the affected arm for a long time.

What methods does the doctor diagnose ailment?

Before the diagnosis of "left-side hemiparesis the doctor conducts the necessary studies that will help to identify the cause of the pathology. How favorable will be the prognosis depends on the onset of development and timely treatment of hemiparesis.

If such a state is suspected in a newborn, the doctor takes into account the following factors when diagnosing a disease: birth, changes in the placenta, whether there was a threat of termination of pregnancy, infection of the urogenital tract in a woman during the period pregnancy. Children entering this risk group should be examined regularly by a neurologist.

In order to timely correct the abnormalities in the child, it is necessary to systematically monitor the state of the brain by performing ultrasound.

From hardware diagnostic methods it is worth noting a computer tomography, magnetic resonance imaging of the brain.

During the examination, the doctor determines the reflexes, the strength of the muscles, which has an evaluation on the following scale:

0 points- movement is limited completely, complete paralysis.

1 point- Slightly reduced muscle contraction, joint movement is completely limited.

2 points- a significant reduction in the volume of movements.

3 points- Movement is limited, but the ability of the limb to move completely is not lost.

4 points- a person can move his hand, the strength of muscles is slightly reduced.

5 points- signs of an illness are absent.

How to treat hemiparesis?

Treatment of hemiparesis primarily involves the identification, as well as the timely removal of the cause that caused the ailment. Since the main cause of the development of pathology lies in the defeat of nerve cells, all forces are directed to repair damaged areas.

Immediately after determining the diagnosis, the doctor prescribes medication therapy, the performance of physiotherapy exercises, which in turn will help to develop the motor function of the affected limbs. If the brain areas are damaged, muscle tone rises.

To reduce it, prescribe drugs that contribute to a gradual decrease in tone. Such drugs are called "muscle relaxants".

Medications are prescribed for a long period, since it is impossible to achieve restoration of the damaged area in a short time, but with their help it is possible to achieve an early rehabilitation.

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In the event that within 12 months from the beginning of treatment there are no positive changes in the affected areas, therapy is continued. At the same time, other disorders that can occur: disturbed vision, speech disorders, epilepsy, etc., are treated.

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Not only are medicines effective in treating left-sided hemiparesis in children. Doctors recommend attending massage and physical education sessions.

LFK in hemiparesis can be carried out at home or visiting rehabilitation centers.

Therapeutic physical training will help to achieve the improvement of the human condition, but only with systematic implementation.

Can hemiparesis be prevented?

Of course, to prevent the emergence of an ailment in a newborn is difficult, and sometimes even impossible, for example, with large fetal sizes, when the use of ancillary equipment is required at the time of delivery. In other cases, prevention, which consists in respecting the right way of life, refers more to a pregnant woman.

If we talk about the prevention of an illness at an older age, its main rule is to prevent the development of those diseases that can be accompanied by hemiparesis. As such, it is worth noting the disease of the heart (vessels), especially the stroke, which often contributes to the appearance of the symptom.

Other recommendations for the prevention of a symptom are:

• diet (eating small portions, consuming enough fruits and vegetables);
• bad habits should be excluded (alcohol and smoking abuse);
• a healthy lifestyle - a method of preventing any disease;
• monitoring of the level of pressure.

And, of course, when the first signs of a left-sided hemiparesis appear, it is worthwhile to contact a specialist who will prescribe the appropriate treatment.Only the timely treatment of any disease will help prevent dangerous consequences.

A source: http://drpozvonkov.ru/nevralgiya/simptomy-i-lechenie-levostoronnego-gemipareza.html

Hemiparesis left-sided and right-sided

Hemiparesis is a neurological disorder in which there is a restriction of the movement of the muscles of the right or left half of the body when the opposite hemisphere of the brain is affected.

The condition is associated with damage to the bodies of cortical motor neurons and the conducting pathways of the brain or (in less frequent cases) spinal cord.

With the progression of the pathological process, there is a gradual decrease in the sensory and motor functions, which causes the development of muscle damage.

Usually, hemiparesis occurs on the side opposite to the damage, which is due to the intersection of the nerve fibers at the site of the medulla oblongata in the dorsal.

Source: neurodoc.ru

Causes and risk factors

With the sudden onset of the disease, its causes are usually neoplasms of the brain, scattered sclerosis, stroke ischemic or hemorrhagic, encephalitis, diabetic encephalopathy, craniocerebral trauma, migraine.

The causes of slowly developing hemiparesis can be: cerebral cortex atrophy, brain abscesses, radiation myelopathy, slowly progressing brain tumors.

The risk factors for developing hemiparesis include stress - either permanent or frequent, and a strong one-fold.

The cause of the development of congenital hemiparesis is usually anomalies in the development of the brain, fetal hypoxia, intrauterine or birth trauma.

Forms of hemiparesis

Depending on the etiology, hemiparesis is congenital and acquired.

Depending on the location of the primary brain damage:

• central - caused by damage to the pyramidal pathway from the cortex to the anterior horns of the spinal cord;
• peripheral - is caused by damage to the nuclei of the cerebellar nerves or cells of the anterior horns of the spinal cord with their axons (cranial nerves or anterior spines of the spinal cord).

By localization:

• right-sided hemiparesis - occurs more often, is characteristic of adults, often accompanied by speech disorders;
• left-sided hemiparesis - is more common in children (is one of the manifestations of cerebral palsy), often accompanied by mental disorders.

In a separate form affecting limbs, spastic hemiparesis is isolated.

According to the nature of leaks:

• acute, or rapidly developing;
• subacute, or slowly developing.

By severity:

• easy;
• moderate;
• deep.

Symptoms

The clinical picture in hemiparesis depends on the localization of the pathological focus and the degree of lesion, and is very diverse.

Common symptoms of hemiparesis are prolonged headaches of varying intensity, rapid fatigue, decreased appetite, weight loss, muscle and joint pain. Hemiparesis of central origin (occurring most often) is characterized by fever, speech disorders, cognitive disorders, seizures similar to epileptic.

With left-sided hemiparesis, the muscles of the left side of the body are weakened, while in the right-sided form of pathology the muscles of the right side of the trunk are affected.

With the congenital form of the disease, as a rule, develops the left-side hemiparesis, which manifests itself in the first months of the child's life.

At the initial stages of the disease, weak active and passive limb movements on the pathology side are observed, asymmetric movements of the upper and lower limbs, forced position of the hands.

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There is a weak support function of the leg of the affected side of the trunk, a violation of fine motor motility, incorrect posture, scoliosis can form.

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In severe hemiparesis, children may experience intellectual disabilities and mental abnormalities. Left-sided hemiparesis is often accompanied by a violation of the imagination, perception of color, three-dimensional perception, disorientation in space.

Right-sided hemiparesis is often accompanied by violations of logical thinking, analytical abilities, acalculia (violation of counting and counting operations).

Spasticity of muscles on one side of the trunk is noted with the central character of the pathology. Such patients have unilateral muscle hypertonia.

Patients complain of stiffness of muscles, impaired motor activity.

In the case of focal brain lesions, the patient has impaired motor function, as well as a decrease in the sensitivity of the right or left half of the body.

In this case, the lower limb on the side of the lesion does not bend when walking, making a semicircular movement through the side. Such patients usually have a high probability of restoring motor functions.

In the case of damage to the nervous tissue or extensive hemorrhage, neurological disorders occur: violation speech and intelligence, epileptic seizures, impaired perception, emotional response, disorders personality.

Diagnostics

For the diagnosis of hemiparesis, a collection of complaints and anamnesis, objective examination of the patient, as well as instrumental studies, the volume and nature of which depends on the form of pathology.

Muscular strength is assessed on a five-point scale adopted by the British Council of Medical Research:

• 0 - no movement;
• 1 - weak muscle contractions;
• 2 - the movements are carried out only in the horizontal plane;
• 3 - the limb rises when there is no resistance;
• 4 - the limb rises with little resistance;
• 5 - the movements are kept in full and force.

To identify the cause of hemiparesis, computer or magnetic resonance imaging, electromyography, and dopplerography of the blood vessels of the brain are carried out.

In children, the diagnosis of hemiparesis is established in one to one and a half years, when children begin to walk and motor disorders become more specific.

Treatment

Treatment of hemiparesis is most effective in the first year after the appearance of neurological disorders.

In the mild form of hemiparesis, therapy consists in conducting a course of therapeutic physical training (can include gymnastics on fitball, swimming, etc.). Shows also general and segmental massage, hydromassage, hippotherapy (treatment with horses), and also hardening procedures.

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Drug therapy is prescribed as needed. Muscle relaxants, anticonvulsant drugs, medicines that improve trophicity nervous tissue and blood supply to the brain, including vitamin complexes (vitamin E, group vitamins AT).

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In the treatment of hemiparesis, methods of physiotherapy are effective: electrophoresis, ultrasound therapy, diadynamic therapy, reflexotherapy, mud therapy. In order to prevent the formation of contractures, joints and muscles resort to physiological fitting of the limbs with the help of longets.

For social adaptation and normalization of the emotional state, a course of psychotherapy may be required. Violations of speech require classes with a speech therapist.

In severe forms of pathology, surgery on the affected muscles may be required.

Possible complications and consequences

Hemiparesis can be complicated by a complete loss of muscle strength on the affected side of the trunk, development of paralysis (hemiplegia).

Forecast

The prognosis depends on many factors, including the cause and severity of the pathology.

With timely diagnosis and properly selected treatment, the prognosis with acquired hemiparesis is usually favorable, in most cases it is possible to completely restore the lost functions. The prognosis for congenital hemiparesis is cautious.

Light forms with persistent therapy are amenable to correction, heavy, despite the efforts made, can only be corrected in part.

Prevention

In order to prevent the development of hemiparesis, it is recommended:

• timely treatment of somatic diseases;
• monitoring of the condition of a woman during pregnancy and fetus;
• prevention of vascular disorders;
• avoid stress and mental stress;
• rejection of bad habits;
• balanced and balanced nutrition;
• sufficient physical activity.

A source: http://www.neboleem.net/gemiparez.php

Hemiparesis: Symptoms and Treatment

Category: Neurology and psychiatry 4129

Hemiparesis, or central paralysis, manifests itself in the limited movement of the muscles of the right or left half of the body.

Progression of this disease due to the negative effects on neurons and axons of the brain. The stage of the lesion is determined by the doctor for the symptomatology.

There is a pathology in right-sided or left-sided, upper or lower lesions of the limbs.

Etiology

Paralysis is formed as a result of impaired functionality of the central motor neurons and axons. That is, the nerve cells and their processes that are localized in the brain and spinal cord are affected. Often, pathology affects one of the hemispheres of the brain.

If the disease affects the right hemisphere, then muscle weakness appears in the left half of the body, and vice versa - with lesion of the left hemisphere, there is a violation of the motor function of the right limbs.

This process is due to the fact that nerve fibers are located crosswise at the exit from the brain.

These causes become factors in the development of the acquired form of pathology. Doctors diagnose it in the adult age category. Often in adults, right-sided hemiparesis occurs, in which the motor activity of the right half of the body is quickly damaged.

But sometimes doctors diagnose a slow progression of pathology. The reasons can be hidden in such ailments:

• slow growing tumors;
• atrophy of the cerebral cortex;
• multiple sclerosis;
• radiation myelopathy;
• syphilis.

Sometimes pathology is formed on the basis of mental problems or stressful situations. In this case, the patient is diagnosed with "pseudoparesis which occurs after the elimination of provoking factors.

Varieties of paresis

Right-sided or left-sided hemiparesis in children develops as a congenital disease, causes the appearance of which becomes abnormal functionality and the structure of the brain or injury childbirth. In medical terminology, this disease is called infantile cerebral palsy (cerebral palsy).

Cerebral palsy is formed because of discirculatory disorders in the circulation of the brain. Such a disorder leads to damage or improper formation of the fetal brain structures at different stages of intrauterine development.

Symptomatology

Clinical manifestations of spasmodic hemiparesis depend on the location of the pathological focus and the degree of brain damage.

With a slow progression, in the first months of the defeat of the brain or spinal cord, the patient develops a muscle tone, which entails for a spasticity, that is, the upper and lower limb of one of the sides become strained, there is a feeling of stiffness in movements. Progress of the clinical picture begins with a wrong or total absence of treatment.

When paralyzes, the patient notes such characteristic symptoms:

• agnosia - a violation of perception;
• broken speech;
• emotional and personality disorders;
• impaired sensitivity in the area of ​​innervation;
• development of unilateral or bilateral inaction;
• frequent epileptic seizures.

Quite often, these symptoms are accompanied by a number of less specific manifestations that are related to a more general symptomatology:

• prolonged headaches;
• fever;
• poor appetite;
• fatigue;
• pain in the joints;
• a significant reduction in weight.

If the patient still exhibits a spasticity, then it informs that the interaction between the brain and limbs is present and possibly a recovery.

When the left hemisphere is damaged, the patient has a characteristic problem with the normal operation of such functions:

• operations with the sequence;
• linear representation;
• score;
• analysis;
• speech;
• logics.

When the functionality of the right side of the brain is impaired, the following failures occur in the patient:

• disorientation in space;
• three-dimensional perception;
• imagination;
• perception of color.

The child with the development of cerebral palsy overcome various symptoms that are more active when the child begins to walk. At an early stage of the manifestation of the disease, such signs are formed:

• asymmetric limb movements;
• forced position of hands;
• it is difficult for the child to rest on his feet;
• with a horizontal position on the abdomen, the affected upper limb is poorly stretched and muscle weakness is noted;
• violated the fine motor skills in the hand;
• incorrect posture;
• gradually formed scoliosis.

Child with cerebral palsy

Diagnostics

For a timely diagnosis of the disease, doctors are advised to regularly take a survey and monitor their own health. If you identify even the weak above-mentioned manifestations, you need to turn to a neurologist.

With an objective examination, the doctor evaluates the weakening of muscle strength, which is measured by a 6-point system:

• 0 points - complete absence of motor activity;
• 1 point - slight muscle contractions with slightly noticeable perturbation;
• 2 points - full movement with support;
• 3 points - the total volume of active limb movement;
• 4 points - an easy reduction of static muscle strength;
• 5 points - full-fledged conservation of limb activity.

To establish the correct diagnosis, the patient is subjected to a general clinical examination. After taking the tests, instrumental examinations are required. To establish the diagnosis of "central hemiparesis you need to explore the brain with such methods:

• CT or MRI;
• Dopplerography of cerebral vessels;
• electroencephalography.

During the diagnosis, the doctor needs to quickly determine the cause of the onset of the disease, since further therapy of the disease depends on this.

Treatment

Treatment of hemiparesis is prescribed by a doctor after determining the source of the disease.

Each patient is selected individual scheme of therapy, which consists in the use of medicines and carrying out activities to improve muscle tone. In this regard, the course of treatment is in such methods:

• taking medications;
• exercise gymnastics;
• water physical education;
• Scandinavian walking;

Scandinavian walking

• therapeutic mud and massage;
• reflexology.

If the pathology was detected in childhood, then if all the doctor's recommendations are followed, the patient can fully recover.

Physiotherapy takes a special place in hemiparesis. Treatment of the patient includes such procedures:

• swimming;
• moderate massage;
• exercises on fitball;
• hardening;
• dousing;
• Charcot's shower.

When complications and severe stages of the disease appear, the patient is prescribed medications from the group of muscle relaxants, quite often they are used in cases of cerebral palsy.

After discharge from the hospital, the patient needs to continue to do the procedures, especially the massages.

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They perfectly help to relax the spasmed muscles, improve blood flow and metabolism on the damaged half of the body.

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It is recommended to use relaxing massage techniques with stroking, rubbing and kneading movements.

Complications

If you do not start on time to conduct therapeutic procedures, the patient may develop complete paralysis, which will lead to irreversible disability. With proper and timely treatment, the patient's chances of a full recovery with the return of lost motor functions increase.

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A source: http://SimptoMer.ru/bolezni/nevrologiya/2333-gemiparez-simptomy

Congenital and acquired hemiparesis

A neurological symptom associated with damage to the motor pathway of pulse propagation to the extremities on one side and manifested by a decrease in strength in the muscles, is called right-sided or left-sided hemiparesis.

Classification of hemiparesis

The level of damage to the conductive path allows us to distinguish the following types of paresis:

• central;
• peripheral;
• mixed;
• psychogenic.

Degree of severity is mild, moderate, deep. Peripheral paresis is called sluggish, and central - spastic. They differ significantly from each other in the clinical picture.

Causes of the disease

This condition can occur in childhood and in adults. Hemiparesis in children is often a congenital disease.

The reason - congenital defect of the brain, cysts, hematomas, ischemic damage in premature infants.

Therefore, in childhood, hemiparesis is considered in the structure of infantile cerebral palsy.

In adults, pathology develops as a result of:

The condition can develop acutely or gradually.

Clinical manifestations

In the first three months of life, the signs of an innate disease are almost invisible. A vivid picture of hemiparesis develops by the time of independent walking. Up to this point, you can notice minor disturbances in movement:

• on the paretic side mobility and active movements are limited;
• the position of the hand is forced - the hand is clamped into the cam, the forearm is turned inside;
• if you hold the child upright, it can not stand on the foot;
• when lying on his stomach does not stretch his hand on the paretic side forward, badly resting on it.

With age, the wrong position of the hand is fixed, the pterygoid protrusion of the scapula develops, the shoulder is shortened. There are prerequisites for the development of scoliosis.

Often, hemiparesis is accompanied by epilepsy, mental retardation, speech disorders. The degree of delay in the development of intelligence depends on the affected hemisphere.

Left-sided hemiparesis in children is caused by damage to the right hemisphere of the brain. They suffer from learning, memory, speech, behavior becomes inadequate.

Epilepsy develops more often in the pathology of the left hemisphere.

Left-sided hemiparesis in adults develops rarely. The most common cause of it is a violation of blood flow in the brain or head trauma. Motor disorders are formed within 2-4 weeks and progressively increase. With insufficient treatment paresis can go to pleygia.

Common signs of the presence of the disease are as follows:

• chronic pain in the head, moderate intensity;
• weakness, poor health, reduced efficiency;
• pain in muscles and joints;
• decreased appetite, body weight;
• periodic temperature rise.

Right-sided hemiparesis after a stroke is accompanied by neurologic symptoms:

• Speech disorders are more characteristic of hemorrhage in the left hemisphere;
• epileptic seizures;
• impaired perception, thinking and learning ability;
• emotional and personality disorders;
• impossibility of purposeful actions.

Diagnosis of hemiparesis

For the purpose of treatment, a thorough diagnosis of the causes of left- or right-sided hemiparesis is necessary. In case of illness in a child, the effectiveness of treatment depends directly on the time of its onset. Diagnosis in newborns is carried out in the presence of risk factors:

• a small number of points on the Apgar scale at birth;
• changes in the placenta;
• severe gestosis, threatened termination of pregnancy;
• infection of the urogenital area in pregnant women;
• chronic hypoxia;
• asphyxiation at birth.

Such children are regularly examined by a neurologist. For the timely correction of neurological disorders, dynamic monitoring of the brain with ultrasound is necessary.

For adults, the diagnosis begins with the collection of anamnesis, laboratory diagnosis of blood indicators (biochemical analysis, glucose, coagulability), CT or MRI of the brain, EEG. On examination, reflexes are determined, muscle strength, which is assessed in points:

• 0 - lack of movement, paralysis;
• 1 - slightly noticeable muscle contraction, there is no movement in the joints;
• 2 - the volume of movement in the joint is reduced, it occurs without overcoming gravity in the plane;
• 3 - the volume of movements is reduced, the limb can move, overcoming the force of gravity and friction, it can be lifted from the surface of the table;
• 4 - slight decrease in muscle strength and stored volume of motion;
• 5 - there is no change in the strength of muscles and movements.

Indicative test Barre, when there is no clear signs of a paresis. The patient is offered to hold the limb on weight for 20 seconds. If there is muscle damage, then it will gradually drop.

Treatment

For the child an individual rehabilitation program is prepared, which is adjusted with age. Treatment of hemiparesis in children is performed by a neurologist, orthopedist, speech therapist, psychologist, physician LFK.

Conservative therapy is an introduction to the spasmed muscles of Botox or Disport. To avoid deformation of the position of the limb, various orthopedic piles are applied with fixation by gypsum, lunette, bandages.

To treat epilepsy, prescribe carbamazepine, gradually increasing the dosage.

Operative treatment of hemiparesis is performed to correct motor disorders in children with pathological deformities of the lower limbs. They spend a gentle crossing of the tendons.

Treatment of left-sided hemiparesis after a stroke is complex.

1. To reduce muscle spasm and the pain caused by it, muscle relaxants are prescribed: Miodocalm, Baclofen.
2. Drugs for activation of cerebral circulation: Cerebrolysin, Cavinton.
3. Anticonvulsants: Carbamazepine, Valproate.
4. Treatment with physiotherapy: electrophoresis, magnetotherapy, diadynamic currents.
5. Massage.
6. Exercise therapy.

Also, classes are conducted with a psychologist and speech therapist to restore cognitive functions, speech. How to conduct gymnastics with hemiparesis, you can see in the video:

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A source: http://GolMozg.ru/diagnostika/gemiparez.html