Hemiparesis and Hemiplegia
| Hemiparesis and Hemiplegia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Hemiplegia refers to a complete lack of motor function. Hemiparesis refers to decreased motor function. Both are usually a result of a problem with the brain
Differential Diagnosis
In alphabetical order. [1] [2]
- Amyotrophic Lateral Sclerosis
- Brain tumors
- Brown-Sequard Syndrome
- Cerebral abscess
- Cerebral Palsy
- Chronic subdural hematoma
- Complicated Migraine
- Congenital structural anomalies
- Demyelinating syndrome
- Guillain-Barre Syndrome
- Inflammatory conditions
- Intracerebral hemorrhage
- Meningitis
- Multiple Sclerosis
- Periodic paralysis
- Psychogenic or hysterical weakness
- Reversible ischemic neurologic deficits (RINDs) last 24-72 hours
- Syphilis
- Thromoboembolic infarction
- Todd's Paralysis
- Transient ischemic attacks
- Transverse Myelitis
- Trauma
Diagnosis
History and Symptoms
- Onset
- Past history
- Associated symptoms/findings
- Pattern of weakness
Laboratory Findings
- Complete blood count (CBC)
- Prothrombin time / partial thromboplastin time (PT / PTT)
- Glucose
- Calcium
- Blood urea nitrogen (BUN) / creatinine
Electrolyte and Biomarker Studies
MRI and CT
Other Diagnostic Studies
- Cerebrospinal fluid (CSF) anaylsis is useful for patients suspected of having multiple sclerosis
Treatment
- Identifying and treating the underlying cause are the best ways to manage hemiplegia and hemiparesis
- Physical therapy
- Occupational therapy
- Orthotics
- Management of blood pressure and blood sugar (cerebral infarction)
Pharmacotherapy
Acute Pharmacotherapies
Surgery and Device Based Therapy
- Assistive devices for general measures
- Surgical management for mass lesions affecting the brain
References
Acknowledgements
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List of contributors: