Spastic Hemiplegia Cerebral Palsy
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Spastic cerebral palsy is the most common form of the disorder, affecting around 70% of all diagnosed cases. Spastic hemiplegia is one of the subtypes of spastic CP that develops after damage to the part of the brain’s hemisphere that controls movement.
Spastic Cerebral Palsy Subtypes
There are several different types of cerebral palsy, all of which are determined based on symptoms and an official diagnosis by a qualified physician. There are also several different subtypes associated with spastic cerebral palsy. Along with spastic hemiplegia, other subtypes of spastic cerebral palsy include spastic diplegia and spastic quadriplegia.
Spastic hemiplegia is a form of spasticity that affects one side of the body (hemiplegia). According to the National Institutes of Health, spasticity is defined as “velocity dependent increased resistance to passive muscle stretch, or alternatively as inappropriate involuntary muscle activity associated with upper motor neuron paralysis.”
According to the Children’s Hemiplegia and Stroke Association, spastic hemiplegic symptoms can vary from child to child and can include:
- Holding one hand in a fist
- Balance and walking difficulties
- Issues with fine motor skills and daily living tasks
- Developmental milestone delays
- Favoring one hand over the over
- Muscle stiffness on one side of the body
- Weakness on one side of the body
- Problems with limbs positioning properly while walking
- Jerky, shaking muscles
- Poor seating positions
The severity of spastic hemiplegia will also vary accord to each child. Cerebral palsy in itself can range from mild to severe. For instance, some children with spastic hemiplegic cerebral palsy can walk, whereas others must rely on a wheelchair or other assistive devices. Others may experience more muscle weakness or pain when compared to another child.
The good news, however, is that like other types and subtypes of cerebral palsy, spastic hemiplegia is not progressive, meaning the disorder itself will not worsen over time.
Spastic Hemiplegia Causes
Spastic hemiplegia is caused by a brain injury, specifically to the motor cortex, or dysfunction, which can happen in numerous different ways. For children with spastic hemiplegia, the disorder is sometimes caused by injuries before, during, or shortly after birth.
Around 70% to 90% of cases of spastic hemiplegia are congenital, while around 10 % to 30% are acquired. Acquired spastic hemiplegia means that that disorder was not genetically inherited. For example, if a physician doesn’t take action when fetal distress is detected, it could lead to brain damage, which in turn could lead to spastic hemiplegic cerebral palsy.
Prematurity is another risk factor for spastic hemiplegia, which can lead to underdeveloped organs, which in turn can lead to a hypoxic brain injury.
Other instances of acquired spastic hemiplegia include placental issues, failure of medical professionals to order a C-section in time, improper use of birthing tools, untreated maternal infections, and untreated infant infections, or other medical conditions such as jaundice.
Spastic Hemiplegia Treatment
As with all forms of cerebral palsy, there is currently no cure for spastic hemiplegia. There are, however, many treatment options available. It’s important to discuss treatment with your child’s physician as each cerebral palsy patient has unique needs.
The most common forms of treatment include:
- Physical and occupational therapy
- Sensory integration
- Strength training
- Nutritional guidance
- Oxygen therapy
- Splinting and casting
- Botulinum toxin (BT) injections
- Speech therapy
Physical therapy is the most commonly used treatment, not only for spastic cerebral palsy but for cerebral palsy in general. For more information on treatment options available, refer to our article, Cerebral Palsy Treatment.
Keep in mind that there no standard approach exists when it comes to treating spastic cerebral palsy and its subtypes. Medical professionals will asses each child’s individual needs and formulate the best treatments, which will typically consist of a team of experts, such as dieticians, pediatricians, therapists, and if needed, special education teachers.
Spastic hemiplegia, especially without proper treatment, can lead to further complications. Many children with spastic hemiplegia are at a heightened risk of developing osteopenia, osteoporosis, fracture, scoliosis, or pain.
It’s crucial to ensure that children with spastic hemiplegia receive proper nutrition. Due to oral motor dysfunctions, they are at risk of malnutrition and aspiration pneumonia. Muscle weakness when swallowing and breathing tend to be an associated condition of spastic cerebral palsy, and when materials from the mouth or stomach get into the lungs, aspiration pneumonia can develop.
Management and care for a child with spastic hemiplegia can be complex. It may take a while before the most beneficial types of treatment for your child’s individual needs are fully established.
However, with the right treatment and guidance, many children with cerebral palsy adapt well. As a parent, knowing what to expect will help your child have a quality life, despite limitations. If you ever are in doubt or have questions, don’t hesitate to reach out to your child’s care team.