Hemiplegia is a form of cerebral palsy that affects
one arm and leg on the same side of the body. “The
majority of children with hemiplegia have normal intelligence,
go to regular, age-appropriate schools, can expect to
have relatively normal function as adults, and have
few problems beyond the physical difficulties of the
arm and leg that are involved.”1
Hemiplegia has also been used to describe children
with mild involvement of one limb (monoplegia),
or involvement of three limbs (triplegia).
Double hemiplegia
is sometimes used to describe cerebral palsy that affects
all four limbs but effects the right and left sides
in different ways.
In most hemiplegia cases, the arm is usually more
affected than the leg, and the problems are usually
worse at the end of a limb.2
The child typically has a harder time with hand, wrist,
ankle, and foot movement than with elbow, knee and shoulder
movements. Significant problems arise related to the
spacicity and growth of these muscles.
Left- or right-hand preference is usually not well
established until 18 to 24 months of age in an average
child, so if your child is showing a preference to one
hand before this time period may be a sign of hemiplegia.
Other early signs to watch out for include a visibly
stronger limb, a hand or thumb held in a fist, or when
they start sitting or standing, falling to the side
affected by CP. Most children with classic hemiplegia
eventually become good sitters.3
A child with hemiplegia may start walking late and
may first start walking on tiptoe. They also may grow
out of this. Unless they are persistent, special braces
or shoes are not necessary, though if your child is
having problems moving or crawling, this is a good time
to start seeing a physical or occupational therapist.
4
After a child is diagnosed with hemiplegia, a full
neurological evaluation is necessary to discern if other
conditions are present and to make sure no other condition,
such as a brain tumor, is causing the child’s
symptoms.5
Caring for a child with hemiplegia is not much different
from caring for a child without a disability, though
talking with an occupational therapist to determine
proper levels of expectations is a good idea. It is
recommended to give your child toys that require two
hands to stimulate the use of the involved hand. Encourage
her to use the involved hand, but don’t push her
to the point of frustration or force her to do things
she is not able to.
1. 1995. Miller, Freeman, and
Bachrach, Steven J. Cerebral Palsy: A Complete Guide
for Caregiving. Johns Hopkins University Press,
Baltimore, Maryland. p. 115
2. Ibid. p. 115
3. ibid. p. 117
4. ibid. p. 118
5. ibid. p. 115
