Hemiplegia refers to paralysis on one side of the body. It can affect the legs, arms, and facial muscles on the left or right side. It is not a condition, but a symptom of other conditions.

Conditions such as stroke, traumatic brain injury, or brain tumors can cause hemiplegia. Depending on the cause, it may be temporary or permanent.

Treatments focus on helping to restore movement to the muscles as well as addressing the underlying condition.

This article reviews hemiplegia’s causes, types, treatments, and more.

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Hemiplegia means weakness or paralysis on one side of the body. “Hemi” comes from the Greek word for half, referring to the fact that hemiplegia affects one-half of the body.

Though there are several potential underlying causes, including genetics, hemiplegia happens due to brain injury.

Some people may refer to hemiplegia as hemiparesis. While some individuals may use the term interchangeably, the National Library of Medicine states the difference is:

  • hemiplegia refers to severe or complete loss of strength
  • hemiparesis refers to a relatively mild loss of strength

A person may be born with hemiplegia or acquire it.

Doctors generally classify the condition as congenital hemiplegia if the brain injury occurs before, during, or soon after birth up until the age of 2 years. If the injury occurs later, doctors may refer to it as acquired hemiplegia.

Hemiplegia affects either the left or the right side of the body.

If the left side of the brain is injured, paralysis occurs on the right side of the body, while injury on the right side of the brain causes symptoms on the left side of the body.

Symptoms can range in severity and can affect people differently. They may include:

A person may also develop symptoms due to a traumatic brain injury unique to the brain injury itself. These may include symptoms such as:

  • changes in behavior
  • difficulty speaking
  • seizures
  • difficulty with concentration, memory, attention, or thinking
  • confusion, agitation, and restlessness

Children with hemiplegia may show signs such as:

  • delayed walking
  • walking on their tip toes
  • keeping one hand fisted
  • favoring one hand over the other before the age of 12 years

Several conditions can cause hemiplegia. The following are some common examples.

Stroke

Stroke is a leading cause of hemiplegia in both children and adults.

In children, the causes of the stroke may go unknown. Two common causes include congenital heart disease and several genetic blood clotting disorders that can cause embolus, thrombosis, or hemorrhage.

How to identify a stroke

Symptoms and signs of stroke come on quickly and suddenly. It is vital for a person to get emergency medical help as soon as possible to help improve their outlook.

Common signs that could indicate stroke include sudden:

  • numbness or weakness in the arm, face, or leg, often on one side of the body
  • difficulty seeing in one or both eyes
  • difficulty understanding speech, confusion, or issues with talking
  • difficulty with walking, loss of balance, lack of coordination, or dizziness
  • a severe headache with no known cause

Brain injury

Brain injury can occur due to blunt force trauma.

Injury may occur due to falls, physical assault, car accidents, and injury during contact sports. If the injury affects only one side of the brain, it can cause hemiplegia.

In babies, brain injury may occur in the womb. Prematurity, brain impairment, and lack of oxygen can cause this.

Brain tumor

Brain tumors can lead to the development of hemiplegia, among other symptoms.

As the tumor grows, it can damage the brain, causing a person to experience worsening symptoms.

Brain infection

Certain infections, such as meningitis, can cause brain damage in severe cases.

If the damage occurs on one side of the brain, it can lead to hemiplegia.

Genetics

Alternating hemiplegia of childhood (AHC) is a type of hemiplegia that often results from a mutation of the ATP1A3 gene. Sometimes, the condition results from a mutation in the ATP1A2 gene.

AHC is a rare disorder in which a child experiences repeated episodes of weakness or paralysis affecting one side of the body. The paralysis may alternate between both sides.

A person may need one or more tests to help diagnose the underlying condition that causes hemiplegia. In some cases, doctors may recommend repeating tests at different times to help determine the cause.

Some possible tests include:

When to seek urgent care

A person should seek immediate medical attention if symptoms appear suddenly. Sudden symptoms, such as muscle weakness or paralysis, can signal a stroke.

A person should call 911 for urgent care. If other people are present, the 911 operator may ask them to perform first aid. If possible, a person should note down when the symptoms first began.

There are several ways of treating hemiplegia and its causes.

A person should work with a doctor to determine the best treatment options for them, as every treatment will differ depending on the individual case.

Physical therapy

Physical therapy can help with improving muscle strength through exercises and stretching.

They may also help improve a person’s balance, coordination, and other movement concerns.

Assistive devices

Assistive devices cover a range of tools a person can use to help improve mobility. According to the American Stroke Association, assistive devices, such as walkers, braces, or canes, can help improve strength and movement.

Modified constraint-induced movement therapy (mCIMT)

This is a form of treatment that forces the person to use the weakened part of their body. Regular therapy can help with improving nerve function.

Occupational therapy

Occupational therapy is a type of therapy that focuses on rehabilitating a person who has experienced injury or disability.

An occupational therapist will support a person in adjusting to life with their condition. Programs may focus on readjusting to social, work, family, and home life.

It is not always possible to prevent hemiplegia from developing, but a person can take some measures to reduce their risk.

People can help avoid blunt force trauma to the head by:

  • wearing a helmet at construction sites, while riding a bike, or when on a motorcycle
  • wearing appropriate safety equipment on work sites and when playing contact sports
  • wearing seatbelts in automobiles

To help prevent stroke, a person can make lifestyle changes to benefit the heart. This can include:

Further measures include:

Though everyone is different and results can vary based on the injury to the brain, a person may be able to regain some strength and function with physical therapy and other treatments.

A person should follow their doctor’s recommendations and participate in therapy as directed for the best chance of good results.

Experiencing hemiplegia can be difficult and stressful. However, there are ways a person can help them adjust.

A person can make changes to their home and daily routine to help improve their safety. Actionable steps can include:

  • installing grab bars in the shower or bath
  • fitting raised toilet seats
  • installing ramps
  • using a tub bench and plastic strips to help limit the risk of slipping
  • installing handheld shower heads
  • using electric toothbrushes, razors, and other small devices
  • using long handled brushes, special cleaning mitts with pockets for soap, and other assistive devices that help with everyday tasks such as washing, combing hair, and brushing teeth

Discussing the condition with friends and family can help a person build a rewarding support network. This may help reduce the risk of mental health issues.

Depending on the severity of their hemiplegia, a loved one or friend may need minimal to significant levels of support.

This can include helping take care of everyday tasks to installing safety features around the house, such as grab bars or new shower heads.

A person may also need additional emotional support as they go through changes in their daily life. They may benefit from psychotherapy, occupational therapy, or simply having a friend to talk with.

People with hemiplegia may also need help with financial support and concerns. They may qualify for financial disability support if they can no longer work.

The following sections provide answers to some common questions about hemiplegia.

What is the difference between hemiplegia and hemiparesis?

People sometimes use the terms hemiplegia and hemiparesis interchangeably.

However, the subtle difference is that hemiplegia refers to severe or complete loss of muscle strength or paralysis, while hemiparesis refers to a generally milder loss of muscle strength.

What is crossed hemiplegia?

Crossed hemiplegia is a type of paralysis that affects one side of the face and the opposite arms or legs.

Hemiplegia is a symptom of brain injury that can occur in children and adults. The characteristic feature is paralysis or weakness, ranging in severity from mild to severe, on only one side of the body.

Several underlying conditions can cause hemiplegia and several different types. A person should seek medical treatment to help improve their outlook and address any underlying conditions.