Hemiplegia

Aka: Hemiplegia, Hemiparesis, Unilateral Paresis, Unilateral Weakness, Unilateral Motor Weakness

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II. Definitions

  1. Hemiplegia
    1. Complete paralysis
  2. Hemiparesis
    1. Partial weakness

III. Causes

  1. Cerebrovascular Accident (CVA)
    1. Thrombosis, Embolism or Hemorrhage
  2. Transient Ischemic Attack (TIA)
  3. Migraine syndrome
  4. Head Trauma
    1. Brain Contusion
    2. Subdural Hematoma
    3. Epidural Hematoma
  5. Todd's Paralysis
  6. Diabetes Mellitus
  7. Brain Tumor (Primary or metastatic disease)
  8. Infection
    1. Brain Abscess
    2. Encephalitis
    3. Subdural Empyema
    4. Meningitis
  9. Nonketotic hyperosmolar coma
  10. Vasculitis
  11. Demyelinating disease
    1. Multiple Sclerosis
    2. Acute necrotizing Myelitis
  12. Hereditary Disease
    1. Leukodystrophies
  13. Congenital or perinatal injury

IV. Symptoms

  1. Sudden unilateral extremity weakness, loss of function
  2. Reflects spinal cord or higher involvement

V. Signs: Lesion localization

  1. General
    1. Cortical lesion signs depend on dominant hemisphere
    2. Subcortical, Brainstem, and spinal cord are the same
  2. See Right Hemiplegia or Right Hemiparesis (dominant)
    1. Aphasia
    2. Cortical sensory loss
  3. See Left Hemiplegia or Left Hemiparesis (nondominant)
    1. Inattention (left sided neglect)
    2. Denial
    3. Constructional Apraxia
    4. Spatial Disorientation

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