Hemiparesis: Causes, Symptoms, Treatment, Prognosis, Complications
Hemiparesis is a resulting condition found in 8 out of 10 stroke survivors. The word ‘hemiparesis’ comes with “hemi” which means one sided and “paresis” which means weakness. Thus, it is a physical condition caused due to cerebral stroke, brain injury, brain tumors and injury in nervous system, in which patients feel one sided weakness with impaired motor skills. Let us understand Hemiparesis in detail including its symptoms, causes, and treatment.
What is Hemiparesis?
Hemiparesis as described is a type of physical condition with weakness in one side of the body parts. The human brain is made of different lobes like Frontal lobe, Occipital lobe, Temporal lobe and Parietal lobe. Each of these lobes has a very significant role. All these lobes and segments of human brain are divided within two hemisphere, left and right. The injury in left or right side of the brain results into the impairment of motor skills.
Hemiparesis with the affected side (left/right) of the brain results into partial paralysis having one sided weakness of face, arms, hands, chest, legs and feet.
Symptoms of Hemiparesis
People with hemiparesis have trouble in lifting their arms and feet, not only that but also in shifting their limbs and body parts. Because of this, they have problem with their daily life activities of eating, dressing, grabbing things or objects and even using washroom.
Another symptom of hemiparesis could be of Pusher Syndrome. The occurrence of this syndrome is characterized by putting more weight on the affected paralytic side compared to the non-paralytic side which is in contrast with other hemiparesis patients. This syndrome mostly happens due to lesions in the posterior Thalamus region on both sides or due to multiple lesions in the right hemisphere.
The type, severity and intensity of hemiparesis symptoms depends upon the location of brain where the stroke occurred, injury happened or a tumour had grown. Generally, the left hemisphere injury of human brain results in the weakness of right side and the right side brain injury hamper the left side movement.
There are types of hemiparesis with partial paralysis having partial motor skill impairment, and also full paralysis of one side of the body known as hemiplegia. So, it is very important to take an immediate action when the condition of hemiparesis appears. Delay may turn a patient with hemiparesis into a patient of hemiplegia with full paralysis.
Other Associated Symptoms of Hemiparesis
Both the left and right hemispheres of the brain have individual roles and motor movements. The left hemisphere is responsible for the right side limb, facial and body movements and vice versa.
Not only that, the left side of human brain also controls language and verbal communication. The right hemisphere coordinates with the left hemisphere and also takes care of some of the human skills with motor movements.
- Left Hemisphere Stroke or Injury: There are many more symptoms, but a person after left hemisphere stroke faces 2 of these below mentioned problems:
- Partial paralysis or sensory disturbances in the right side limbs, hands, legs, feet and even in facial muscles.
- Hemianopia (reduced vision of right side of both eyes).
- Agnosia (problems with object recognition).
- Chronological problems (problems with time, cause, effect).
- Reduced analytical skills.
- Low memory and verbal skills.
- Chances of mood swing rapidly and easily overwhelmed by emotions.
- Right Hemisphere Stroke or Injury: Stroke in the right hemisphere can generate the following symptoms:
- Weakness or hemiparesis in the left side of the body.
- Sensory impairment.
- Left Neglect or denial of having paralysis and significant reduction of insight into the problem that stroke has caused.
- Visual problems like blurred eyesight.
- Problems with spatial orientation and direction.
- Inability to comprehend maps.
- Inability to identify or find objects.
- Inability to identify or locate different body parts.
- Behavioural issues like depression, inappropriateness, impulsivity, etc.
- Problems with memory.
These left and right hemispheres are also divided into lobes (Frontal lobe, Occipital lobe, Temporal lobe and Parietal lobe). So, the hemisphere injury along with the type of lobe affected produces hemiparesis and the other specific symptoms. The degree of injury is high with cerebral strokes; cerebral strokes most often result in hemiplegia (complete paralysis) instead of hemiparesis.
Prognosis of Hemiparesis
Hemiparesis with partial paralysis can be recovered. Approximately, 70% of patients can gain functional ability of their hands with physical therapy/alternative physical therapy. However, severe forms of movement disability or hemiplegia are usually found permanent.
The degree of recovery solely depends upon the degree of injury in the brain. While the cases of hemiplegia due to stroke is found permanent or with zero percent recovery; the patients of hemiparesis due to head injury, brain tumour and viral infection in brain have the possibilities of recovery with prompt action of removing brain tumour or treatment of head injury or viral infection.
The appropriate rehabilitation with physical therapy increases the chances of recovery.
Causes of Hemiparesis
Hemiparesis resulting in movement disabilities of one side of the body is the result of the brain injury as the result of damage in brain, motor neurons and spinal cord.
Complications of Hemiparesis
There are types of hemiparesis (partial paralysis) according to the degree and type of injury. These include:
- Ataxia: Problems with walk and balance is caused mainly if the lower part of brain is affected. This part is responsible for the body’s balance and coordination for walking, cycling and other such activities.
- Motor Hemiparesis: It is a type of hemiparesis with one sided weakness in arm, leg and facial muscles. In case of Motor Hemiparesis, it affects one body part more than the others.
- Ataxic Hemiparesis Syndrome: It is also another form of hemiparesis with weakness of one sided limbs of an individual who suffered from strokes or other brain injuries. Symptoms of ataxic hemiparesis syndrome are found within a period of hours to days. In this case, leg is more affected than the arm.
Diagnosis of Hemiparesis
Early diagnosis helps to treat and get recovery as early as possible for all the diseases and same goes for hemiparesis as well.
A proper clinical diagnosis with CT scan and MRI (Magnetic Resonance Imaging) helps to understand the brain injury with the affected areas or lobes and even injuries in spinal cord.
Where patients with hemiparesis come with partial paralysis, patients of hemiplegia show complete paralysis. Early diagnosis and treatment may help hemiparesis patient before the condition becomes more severe and turns into hemiplegia.
Treatment of Hemiparesis
Rehabilitation and home based exercise with physical therapy can improve the mobility of the limbs of affected side slowly. Regular activity and practice with repetition can improve the control on the limbs of an individual with hemiparesis. It can also rebuild the neural connection.
A patient of hemiparesis must be under the hands of qualified and certified physiatrists, physical therapists with knowledge of limb movements to treat disabilities, speech therapists and occupational therapists.
There are types of treatment which are mentioned below:
- Botox/Baclofen for Hemiparesis: There are a number of studies which demonstrate that if the limbs are tightened up and are difficult to move, then relaxing the muscle helps to make them move easily. Injection of Botox and application of Baclofen helps to relax the muscles and thus improve the condition.
- Cortical Stimulation to Treat Hemiparesis: This therapy is focused on the stimulation of the “Cortex” region of the brain. In this case, an electrode is placed on the membrane which is covering the brain of an individual. Electrode is set to send small electrical impulse to brain while the individual is doing rehabilitation exercises.
Lifestyle and Coping with Hemiparesis
In addition to rehabilitation, certain types of home modifications and change of lifestyle can help an individual to deal with hemiparesis. Below is a list of simple home modifications required for patients with hemiparesis:
- Raised toilet seat helps a patient with partial paralysis to sit easily.
- Tub bench also helps an individual to sit comfortably into the bathtub to get bath.
- Using plastic adhesive strips on the bottom of the bathtub to prevent it from moving.
- Usage of electric toothbrushes and razors.
People need to be aware of the result of brain injury or stroke, which may come with hemiparesis or hemiplegia at the later stage. An early diagnosis can get the recovery very soon with right treatment, and regular rehabilitation exercise under observation of physiatrists and physical therapists with a little modification of lifestyle can recover a patient of hemiparesis.