Last updated date: 16-Jun-2023
Originally Written in English
About 80% of persons who suffer a stroke also have some difficulty moving one side of their body or have weakness on that side. The words hemi and paresis signify one side and weakness, respectively. Although multiple sclerosis, brain tumors, and other illnesses of the nervous system or brain can sometimes cause hemiparesis, the condition is most frequently brought on by either cerebral palsy or stroke. Hemiplegia, which involves the paralysis of one side of the body instead of weakening, is related to hemiparesis. Hemiparesis can be brought on by a variety of conditions, although it most frequently develops as a side effect of another disease. Depending on how someone acquired hemiparesis, there are several treatment methods available.
Hemiparesis is known as a partial weakness on one side of the body. It could affect the face, arms, hands, legs, or a combination of those. Hemiparesis is most frequently caused by stroke; it affects 80% of stroke survivors. When a blood vessel supplying the brain bursts or is blocked, brain cells are injured, which leads to a stroke. Hemiparesis patients are nevertheless able to move their damaged side of the body, albeit weakly.
Hemiparesis vs Hemiplegia
Weakness on one side of the body is a sign of hemiparesis. Hemiparesis patients may have difficulty moving their arms, or they may just experience tingling or other strange feelings on one side.
Body paralysis on one side is referred to as hemiplegia. Though many misconceptions about paralysis imply that it renders movement impossible, the truth is a little more complex. People who are paralyzed may still have some sensation, and their level of paralysis may vary over time. Thus, it might be challenging to distinguish hemiparesis and hemiplegia, especially when there is a difference between mild hemiplegia and severe hemiparesis.
Forms of Hemiparesis
Hemiparesis patients may have trouble walking and moving their arms and legs, and they may also lose their balance. As a result, carrying out regular tasks including getting dressed, eating, grabbing things, or using the bathroom may be tougher. The extent of a person's loss of abilities after a stroke or hemiparesis depends on the part of their brain that has been injured.
involves damage to the person's left side of the brain. Speaking and language are controlled by the left side of the brain in people. This kind of hemiparesis can make it difficult for a person to distinguish between left and right, talk, and understand what other people are saying.
involves damage to the right side of the brain, which is responsible for learning, some behavioral patterns, and nonverbal communication. An injury to this region of the brain may also result in excessive talking, a lack of concentration, and memory issues.
The ability of a person to orchestrate the movement of their body may be affected by injury to the lower part of their brain. Ataxia is the result, which can make it difficult to walk and maintain balance or posture.
Pure Motor Hemiparesis
The most typical kind of hemiparesis is pure motor hemiparesis. This kind of hemiparesis causes weakness in the face, arm, and leg of the affected person. The person's body parts may be affected equally by the illness or it may favor some body parts over others.
Ataxic Hemiparesis Syndrome
One side of a person's body may be weak or clumsy due to ataxic hemiparesis syndrome. The affected limb is frequently the leg rather than the arm. The symptoms appear from a few hours to several days.
Injury or disease of the neurological system, which includes the brain, spinal cord, and nerves, frequently results in hemiparesis. Hemiparesis can result from a variety of other medical problems in addition to stroke:
- Brain damage caused by trauma such as from a sports injury, a fall, or a vehicle collision
- Nerve or spinal cord trauma, which affects the portion of the nervous system that links the brain to the remainder of the body,
- Brain or spinal cord tumor or other abnormal development of tissue.
- In the autoimmune disease known as multiple sclerosis (MS), the immune system wrongly targets the nerves' protective sheath.
- Medical problems that might limit a person's capacity to walk and move, such as cerebral palsy are present from birth.
- Brain, spine, or meninges (protective tissue that covers the brain and spinal cord) infection.
- Postictal paralysis is a transient weakness following a seizure.
- Psychiatric and psychological disorders can lead to momentary lethargy.
Weakness of one side of the body is the most noticeable sign of hemiparesis. The injured side of the brain or spine is reflected in the symptoms.
The right side of the body often becomes weak after a brain injury to the left side. Weakness on the left side of the body is frequently the outcome of a right-side brain injury.
Hemiparesis may affect the same side of the body as the spinal injury or it may affect the opposite side, depending on the type of spinal injury and the degree of injury within the spine. Hemiparesis symptoms can also include:
- Having trouble staying balanced
- Having trouble walking
- Not being able to grasp objects
- Decreased movement precision
- Muscle fatigue
- Lack of coordination
- Standing, moving, or sitting while tilting to one side.
- Lack of bladder or bowel control
Hemiparesis, which most frequently affects the arms, legs, or both, is one of the main causes of disability because it makes it challenging to maintain a normal level of independence in daily tasks.
Your healthcare professional will perform a physical examination if you complain of any hemiparesis symptoms. It can be challenging to discern whether your symptoms are driven by pain, weakness, or another source.
You will be tested on your reflexes, sensation, and strength throughout the physical examination. Your medical professional will give you a strength assessment on a scale of 1 to 5.
This rating can be used as a standard when the same health professional or other healthcare professionals evaluate your strength at a later date.
Imaging of the brain or spine can also be used to confirm the diagnosis of the cause of hemiparesis or hemiplegia and may include:
- A computer and several X-rays are used in computerized tomography (CT) scans to produce a three-dimensional image.
- A magnetic field and computer are used in magnetic resonance imaging (MRI), which produces two- or three-dimensional images.
Muscle Strength Rating Scale
- The following is the rating scale for muscle strength:
- 0/5. Not moving
- 1/5. Muscles twitching a little.
- 2/5. Side-to-side movements, but the arm or leg cannot be raised against gravity.
- 3/5. able to move against gravity but not against other forces, such as a light push from the examiner
- 4/5. Can move against the examiner force, but not with the strength that would be expected.
- 5/5. able to move with expected strength against force.
People with hemiparesis can benefit from rehabilitation by learning new techniques for using their arms and legs. Hemiparesis sufferers may eventually regain movement if they receive prompt medical attention. A variety of experts are involved in hemiparesis rehabilitation.
Doctors with a focus on rehabilitation are called physiatrists. People who have had a stroke, like those with any other condition, need to be treated by a medical professional who is knowledgeable about both traditional methods and cutting-edge therapies. Someone who has had a stroke can benefit from the supervision of the rehabilitation process by a physiatrist.
Physical therapists can assist with issues with endurance, strength, and range of motion because they specialize in addressing difficulties associated with heavy activity. Through balance and coordination exercises, a physical therapist can help someone who has had a stroke regain the use of their legs and arms.
After a stroke, occupational therapists can assist patients with performing daily tasks and fine motor skills. They might also help people understand how to modify their surroundings to meet changing needs. Medical science has developed or is researching, several promising new treatments for patients with hemiparesis that can also aid those who have had a stroke in regaining movement in their legs and arms.
Hemiparetic patients have had their arms strengthened and their range of motion increased with the application of electrical stimulation. Small electrical pads are placed on the person's weak arm muscles, and a tiny electrical charge is applied to help the person's muscles contract as they attempt to move the arm. These electrical stimulation devices can now be utilized in a person's home because many of them are covered now.
Cortical stimulation, which involves applying electrical stimulation to the brain's cortex, is being studied by researchers to see if it might help people move their arms and hands more freely. A small electrode is applied to the membrane enclosing the patient's brain throughout the procedure. While the person engages in rehabilitation exercises, the electrode transmits very little electrical current to the person's brain. The therapy is only intended for patients who can move their wrists and fingers to some extent at this time.
Botox and Baclofen
Numerous studies have shown that specific therapies may help persons with tone or spasticity relax their muscles. The person has rigidity in a specific body area on the side that is affected and finds it difficult to move. Baclofen therapy and Botox injectable therapy could also help the issue.
Motor Imagery (MI)
Areas of the brain and muscles can become active when a person visualizes using a certain part of their body, making it appear as though they are performing the activity. Mental training, often known as Motor Imagery or MI, aids individuals in visualizing or imagining their limbs moving. It has been suggested that MI can be used to assist persons in walking and that the practice can help hemiparesis patients move their arms more easily.
Modified Constraint-induced Therapy (mCIT)
People with hemiparetic arms who participate in mCIT therapy see a therapist three times per week for a half-hour session for ten weeks. The person uses their weak arm to perform focused exercises at that time and for a few hours each day at home. Studies have shown that modified CIT increased a person's arm's function and range of motion. Modified CIT, however, only works for persons whose wrists and fingers still retain some range of motion.
To resolve the hemiparesis or stop its progression completely, the underlying condition of the patient may also need to be treated in conjunction with the hemiparesis. The patient's treatment includes physical therapy as a crucial component. Therapy helps patients regain control over their muscles and strengthen them. A person may also receive adaptive advice from physical therapists on how to function in an environment designed for people with equal muscle strength on both sides of their body. For those who struggle to walk due to hemiparesis, assistive devices such as wheelchairs, braces, and walkers may be useful.
How Long Does Hemiparesis Recovery Take?
Each person's neurological injury recovery is unique since each injury is unique. Each person's brain is uniquely wired, and each injury affects particular neurological circuits.
Every person has a different form of hemiparesis. Every neurological lesion recovers differently since every person's brain is wired slightly differently. Predicting the course and timing of recovery is therefore sometimes difficult. However, some broad patterns can give you a better idea of what to anticipate.
The brain goes through a period of increased adaptability after a stroke or other brain injury as it works to recover from the damage as quickly as possible. Many survivors are familiar with a plateau that is produced when this stage slows down. The third month is usually when this plateau appears. Hemiparesis sufferers can make amazing progress during this period, especially if they attend both inpatient and outpatient therapy sessions often.
Recovery after three months depends on your continued compliance with at-home therapy. Survivors frequently maintain their degree of competence when rehabilitation and home programs are ignored. However, recovery can continue if rehabilitation is continued even after pausing for months or years.
Hemiparesis is a secondary consequence of neurological damage. Fortunately, neuroplasticity enables the central nervous system to heal and restore itself. This is how new, improved, and rearranged brain circuits are formed. Hemiparesis patients can improve movement on their weakest side through mass practice and other rehabilitative procedures. Because neuroplasticity needs repetition and consistency to happen, home therapy must be persistent.
Hemiparesis, a weakness on one side of the body, can make it challenging to move around and carry out daily tasks. The most common cause is a stroke, although it can also happen as a result of other illnesses or insults to the neurological system. Therapy and rehabilitation can assist with strength and mobility improvements over time and are crucial components of the recovery process.