hemiplegia

Question 1

Hemiplegia

Answer 1

Is a non-progressive condition of paralysis on one side of the body as a result of a brain lesion

Question 2

Occurs on the side of the body

Answer 2

opposite to the side on which the brain lesion has occurred

Question 3

Depending on the location and extent of damage to the brain

Answer 3

, the effects may be temporary or permanent
They also range from almost imperceptible to severely disabling with profound spasticity and extreme sensory or perceptual loss

Question 4

Causes

Answer 4

Most common – cerebrovascular (stroke)
Thrombus – 66%
Embolisms – 5% to 14%
Hemorrhage – 14% to 20%
results in a disturbance in the blood supply to the brain
Head trauma
Brain tumour

Question 5

Risk Factors Under Your Control

Answer 5

High blood pressure (hypertension)
High blood cholesterol
Diabetes
Overweight
Heart disease
Excessive alcohol consumption
Physical inactivity
Smoking
Stress

Question 6

Risk Factors Not Under Your Control

Answer 6

Age
Gender
Family History
Ethnicity
History of stroke or TIA

Question 7

5 Warning Signs of Stroke

Answer 7

Weakness - Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary.

Trouble speaking - Sudden difficulty speaking or understanding or sudden confusion, even if temporary.

Vision problems - Sudden trouble with vision, even if temporary.

Headache - Sudden severe and unusual headache.

Dizziness - Sudden loss of balance, especially with any of the above signs.

Question 8

Symptoms

Answer 8

Acute phase – flaccidity of muscles on affected side; no spasticity or reflex patterns are evident
-Gradually, spasticity and reflex patterns will develop. Some flaccidity may remain.
-Spasticity occurs because lesions have interfered with the brain’s control over spinal cord activity
-The result is uninhibited alpha motor neuron firing
-This type of paralysis will take on particular flexor and extensor patterns reflecting the uninhibited dominant reflexes
-Altered posture
Due to spasticity
-Most common pattern is a flexor pattern in the upper limbs combined with an extensor pattern in the lower limbs
-Altered gait - circumducted
-Hemiplegic shoulder
Painful condition; results in adduction and internal rotation of the GH joint combined with the retraction of the scapula
Seizures
Edema
Pain
Shoulder-hand syndrome
Decreased ROM of shoulder and hand, followed by throbbing pain and edema
Compensatory changes of unaffected side and overuse syndromes
Sensory deficit – light touch, temperature and pain perception, two-point discrimination and proprioception
Neglect of affected side
Behavioural and emotional changes
Visual impairments
Speech difficulties
Cognitive impairment

Question 9

Brunnstrom Stages of Recovery

Answer 9

1. Flaccidity (immediately after the onset)
   No “voluntary” movements on the affected side can be initiated
2. Spasticity appears
   Basic synergy patterns appear
   Minimal voluntary movements may be present
3. Patient gains voluntary control over synergies
   Increase in spasticity
4. Some movement patterns out of synergy are mastered (synergy patterns still predominate)
   Decrease in spasticity
5. If progress continues, more complex movement combinations are learned as the basic synergies lose their dominance over motor acts
   Further decrease in spasticity
6. Disappearance of spasticity
   Individual joint movements become possible and coordination approaches normal
7. Normal function is restored

Question 10

*Synergy –

Answer 10

A whole series of muscles are recruited when just a few are needed. For example, when trying to reach forward, the arm abducts, the shoulder elevates, the wrist flexes. Lots of this is from spasticity