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Hemiplegia (sometimes called hemiparesis) is a condition that
affects one side of the body (Greek 'hemi' = half). It is caused by
injury to parts of the brain that control movements of the limbs,
body, face, etc.
This injury may happen before, during or soon after birth (up to
two years of age approximately), when it is known as congenital
hemiplegia (or unilateral cerebral palsy). If this happens later in
life as a result of injury or illness, it is called acquired
hemiplegia. We also talk about a right or left hemiplegia,
depending on the side affected. Generally, injury to the left side
of the brain will cause a right hemiplegia and injury to the right
side a left hemiplegia.
Hemiplegia is a relatively rare condition, affecting up to one
child in 1,000. About 80% of cases are congenital, and 20%
acquired. Hemiplegia affects each child differently.
You may be told that hemiplegia is a form of cerebral palsy,
which is a descriptive name for a wider group of conditions in
which movement and posture are affected owing to injury to the
brain. These conditions are lifelong and non-progressive, which
means they do not get worse. They may look different over time,
partly because the child is growing and developing.
The causes of congenital hemiplegia are mostly unknown. Usually
parents only become aware of their child's hemiplegia during
infancy or early childhood as the child's difficulty with movement
on one side gradually becomes obvious.
There is a higher risk in very premature babies and with
multiple pregnancies, and it is unclear whether a difficult birth
may be an occasional factor. But in most cases the injury occurs at
some point during pregnancy, and researchers have, as yet, been
unable to isolate any contributory factors. Some studies suggest
that there could be an increased risk in communities where marriage
between close relatives is common.
Parents often worry that they may be somehow to blame, but this
is not the case as it would appear to be mostly a matter of chance.
A research study on twins, where one twin has hemiplegia, suggests
that nothing the mother (or father) did or didn't do during the
pregnancy affected the child's hemiplegia.
Acquired hemiplegia results from brain injury. The most common
cause is a stroke (when a bleed or blood clot damages part of the
brain), but it can also result from a head injury or infection.
If your child has acquired hemiplegia, which results from damage
to the brain during childhood, you have exactly the same risk as
any other person of another child having hemiplegia - approximately
one in 1,000. If, however, your child has congenital hemiplegia,
your risk is slightly increased, although it is still extremely
unlikely to occur. You can ask for a genetic test to determine
whether there is any genetic reason for your child to have had a
bleed, but there is only a 1-2% chance of this.
It is difficult to generalise: hemiplegia affects each child
differently. The most obvious result is a varying degree of
weakness, stiffness (spasticity) and lack of control in the
affected side of the body, rather like the effects of a stroke.
In one child this may be very obvious (he or she may have little
use of one hand, may limp or have poor balance); in another child
it will be so slight that it only shows when attempting specific
Most children say that their affected hand feels heavy, tense or
tired and stiffer than the other side and that these feelings
greatly intensify after exercise. Many feel hot or cold
temperatures more acutely with the affected hand, although in
others the feeling is so impaired that the child cannot tell the
difference between the two temperatures.
Children sometimes say that when they touch something with their
affected hand, it is as though that hand is wearing a very thin
glove. Most children say that they forget their hand is there -
which is when their hand closes into a tight fist. Very few, if
any, children complain of pain, tingling or numbness in the
Yes, there may be. Because hemiplegia is caused by injury to the
brain, it is not just motor pathways and motor development that may
be affected. And despite the developing brain's effort to relocate
functions to undamaged areas, approximately half of children do
have additional diagnoses.
Some of these additional diagnoses are medical in nature, such
as epilepsy, visual impairment or speech difficulties. Many
children have less obvious additional challenges, such as
perceptual problems, specific learning difficulties or emotional
and behavioural problems. Each child should be fully assessed and
regularly monitored to identify if any of these associated problems
As the child grows these difficulties may become more
frustrating and disabling than the more obvious physical ones, but
with multidisciplinary management their effects can be reduced.
Find out more about problems associated with
Hemiplegia cannot be cured, but a lot can be done to minimise
its effects and help children achieve their potential.
Understanding hemiplegia and knowing how you can help your child
achieve his or her potential is vital.
Make good use of the specialists dealing with your child's
hemiplegia. Do ask them questions and make sure you understand
their replies, if necessary asking them to repeat them using non-
Find our more about how hemiplegia is
The most common questions we are asked are:
Nearly all children with hemiplegia will eventually walk and
talk, although they may be a little later than their peers. Many
children with hemiplegia do a kind of 'bottom shuffle' instead of
crawling, but this is very normal and just means trouser bottoms
wear out instead of trouser knees!
Some children have other problems in addition to their
hemiplegia, which may have an impact on walking and speech.
No, although as your child grows you may find that their
hemiplegia affects more aspects of their development than is
immediately obvious. Nor will it get better. Hemiplegia as a
condition does not change much. However, its effects can be
minimised with appropriate therapy.
Most children and young people with hemiplegia attend mainstream
schools, with or without some extra support. It is essential to
give teachers as much information as possible about your child and
how best to help him or her.
Find out more about support in education.
In general, all children with hemiplegia have full bladder
control but it might be slightly later than average. However,
because of the difficulty some children have with undressing, they
might have a lot of 'accidents' at the beginning. Trousers with
elasticated waists make life easier for a child - see our
information on dressing.
Many people with hemiplegia are able to drive a car, although
they usually need automatic gears, power steering and steering and
indicator adapters. They will not, however, be able to obtain a
licence if they have epilepsy or severe eye problems. See our
driving page for more information.
Life can be difficult for children and young people with
hemiplegia who want to do the same things as other children. They
tire more easily and the effort involved in simple tasks can be
considerable. They need all the help and encouragement you can give
them. And you need support in your turn - ideally from other
parents and carers who understand how you feel and with whom you
can also share ideas and information.
We have lots of advice and support on our site, from finding a local
support group, accessing social care services, benefits and money help,
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