Hemiplegia

Hemiplegia is paralysis of one side of the body, typically caused by damage to the brain or brainstem that disrupts the motor pathways, particularly the corticospinal tract. It affects the arm and leg on the same side and may involve facial weakness. Hemiplegia is not a disease in itself but a symptom of an underlying brain disorder.

Most cases arise from brain injury or disease, with stroke being the most common cause (ischemic or hemorrhagic). Other causes include traumatic brain injury, brain tumors, infections such as encephalitis, and congenital or perinatal brain injury in children. In some disorders, hemiplegia can be part of a progressive process or a long-term consequence of early brain injury.

Symptoms vary by the site and extent of damage. In acute stroke, the affected side may be weak or paralyzed, with facial droop and sensory loss. Over time, spasticity and abnormal reflexes may develop, and there can be difficulties with movement, balance, and daily tasks. Language or cognitive changes may occur if the dominant hemisphere is involved.

Diagnosis relies on clinical examination and imaging. Neurological assessment is followed by CT or MRI to identify the lesion and guide treatment. Additional tests may assess underlying vascular risk factors or other contributing conditions.

Treatment aims to address the cause and maximize function. Acute management of stroke, when applicable, may include reperfusion therapy. Rehabilitation is central and multidisciplinary, including physical, occupational, and speech therapy. Medications may prevent recurrence and manage risk factors, while rehabilitation and assistive devices support independence and safety. Prognosis varies with cause, extent of injury, and access to rehabilitation.