Hemiplegia
What is Hemiplegia?
Hemiplegia is a state of severe or complete paralysis ("plegia") that affects one half ("hemi") of the body. It is often the result of brain damage at birth that affects the body’s ability to control muscle movement.
Hemiplegia is a relatively common symptom of cerebral palsy along with other paralyzing movement disorders like monoplegia, diplegia, and quadriplegia. Researchers estimate that approximately 33-39% of children with cerebral palsy receive a hemiplegic diagnosis.
Children with hemiplegia may require a range of ongoing medical treatments and therapies throughout their life to maintain full mobility. Physical therapy and occupational therapy programs can strengthen their motor skills and encourage a stronger sense of independence. Additionally, medical procedures and medications can alleviate symptoms and ease chronic pain.
But the cost of these treatments can place a heavy financial burden upon some families. No family should have to sacrifice these vital birth injury treatments just to stay afloat paying everyday bills and expenses.
Proper medical care during birth can sometimes prevent life-altering brain injuries that cause cerebral palsy symptoms. While some brain injuries are unavoidable, negligent action during labor and delivery can increase the risk of neonatal brain damage.
Families may be eligible for compensation when they can trace their child’s cerebral palsy diagnosis back to mistakes during birth. When a healthcare professional’s negligence leads to permanent and preventable injuries, it may constitute medical malpractice.
Our firm helps families prove medical malpractice to recover the compensation needed to afford life-changing treatment for conditions like hemiplegia.
Cerebral Palsy Malpractice Attorneys
Our top rated cerebral palsy attorneys specialize in birth injury medical malpractice. We understand how medical mistakes during delivery can cause brain injuries that permanently impact a child’s life.
If your baby’s preventable birth injuries led to a cerebral palsy diagnosis, don’t hesitate to contact our firm. We can answer difficult legal and medical questions and investigate the facts on your behalf.
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Cerebral Palsy Lawyers
(888) 987-0005Our Cerebral Palsy Lawyers are available to meet you in your home or the hospital.
Our vast network of medical experts and in-house nursing staff and nurse-attorneys gives us the edge over our competition. When we take your case, we assign you with not just an attorney but an entire medical team. This team includes attorneys, experienced nursing advocates, and seasoned medical experts.
We understand the extensive care your child requires to assist with their cerebral palsy symptoms. Your team is available to assist with any day-to-day treatment you or your child may need. This includes assistance with obtaining medical records, scheduling doctors’ appointments, providing transportation, and any other problems that may arise.
We offer all of this on a contingency fee basis. This means you will not pay any fees until after we win your case and secure a settlement. We have an unmatched track record of birth injury results that sets us apart from other birth injury law firms.
Recent Birth Injury Settlement:
Cerebral Palsy Birth Injury settlement against a hospital in which nurses and physicians failed to detect a uterine rupture during delivery causing an HIE event which caused cerebral palsy. Our dedicated cerebral palsy birth injury lawyers recovered $9,200,000 for the family to help with future medical expenses and developmental therapy.
What Are the Four Main Types of Hemiplegia?
All hemiplegia results from an injury to one side of the brain. But an injury to one side of the brain causes paralysis on the opposite side of the body. This means a child with hemiplegia affecting their right side actually sustained injuries to the left side of their brain.
A birth injury to one side of the brain can cause a child's muscles to become completely limp. This most commonly causes spastic hemiplegia, a type of paralysis in which the muscles tighten and contract uncontrollably. But several types of hemiplegia exist, each stemming from different types of neurological damage affecting the brain or spinal cord.
Every kind of hemiplegia involves paralysis or weakness on one side of the body. However, symptom severity and the most affected body parts will depend on where specifically the injury in the brain occurs.
The four types of hemiplegia include:
Facial Hemiplegia
Those affected by facial hemiplegia may experience muscle weakness or complete paralysis on one side of their face. This form of hemiplegia may also occur alongside complete/incomplete hemiplegia in other areas of the body.
Children with facial hemiplegia may experience muscle weakness or complete paralysis on one side of their face. Facial hemiplegia may occur alongside complete/incomplete hemiplegia in other areas of the body.
Neurological conditions like neonatal strokes can disrupt blood flow to the brain and affect facial muscle control. In some cases, facial hemiplegia may only temporarily affect the child. It can sometimes resolve once the stroke ends and normal blood flow returns to the brain.
Facial hemiplegia is a subtype of facial palsy, which refers to any paralysis affecting the baby’s face.
Cerebral Hemiplegia
This type of hemiplegia occurs at birth whenever a birth-related head injury interrupts blood flow to the brain. It is often a symptom of cerebral palsy or another neurological condition.
Cerebral hemiplegia during or shortly after birth typically affects the area responsible for controlling motor functions. This leads to a range of symptoms such as difficulty with movement, muscle control, and coordination.
Cerebral hemiplegia can vary in severity. Some children only experience mild muscle weakness, while others face more significant limitations, including muscle spasms or sometimes complete paralysis.
Spastic Hemiplegia
Spastic hemiplegia is a form of hemiplegia causing both paralysis and spastic movements on the affected side.
The term "spastic" refers to the spasticity, or the involuntary stiffness, that individuals with this condition experience. Spastic and hemiplegic symptoms will most often result in a child’s spastic cerebral palsy diagnosis.
Spastic cerebral palsy is the most prevalent classification of cerebral palsy, with the arm usually stiffer than the leg. Children with spastic hemiplegia often exhibit stiff, rigid movements. On the other hand, children with flaccid hemiplegia experience weakness and loose, floppy muscles.
Spastic hemiplegia can lead to chronic muscle pain, limb deformities in severe cases, and difficulty with walking or maintaining motor control. The severity and duration of symptoms can vary significantly from one individual to another.
Spinal Hemiplegia
Spinal hemiplegia, also known as Brown-Sequard Syndrome, is a relatively rare condition stemming from a spinal cord injury at birth. It is more likely to occur from injuries above the C6 portion of the spinal column.
This condition occurs when damage to one side of the spinal cord causes paralysis of the same side (ipsilateral). The child will lose all sensation (including any feelings of pain and temperature) on the opposite side (contralateral).
In spinal cord injuries, right hemiplegia refers to paralysis on the right side of the body. Left hemiplegia involves paralysis on the left side following injury to the left side of the spinal cord.
In most cases, spinal hemiplegia results from an incomplete spinal cord injury (SCI) rather than a complete SCI. While an incomplete SCI leads to paralysis on one side of the body, a complete SCI occurs completely severs the spinal cord. This usually results in total paralysis on both sides of the body below the injury site.
What Causes Hemiplegia?
Hemiplegia results from an injury or abnormality in the brain or spinal cord that disrupts motor function. Depending on the location and severity of the injury, hemiplegia can either be temporary or permanent.
There are numerous causes of hemiplegia in children, many of them occurring as a symptom of brain damage at birth.
The most frequent causes of hemiplegia include:
Ischemic Events
The most common cause of hemiplegia involves vascular conditions that affect blood flow to the brain. Strokes, aneurysms, and cerebral hemorrhages can all result in a blockage in blood flow that causes ischemia.
A stroke, for example, disrupts blood flow to specific areas of the brain. This interruption, even temporary ones like a transient ischemic attack or “mini stroke”, can lead to cell death and permanent damage.
Other injuries like intracranial hemorrhages or even oxygen deprivation from birth asphyxia can affect blood flow to the brain.
When severe, these ischemic brain injuries can induce weakness or paralysis on the opposite side of the baby’s body. Medical errors like missing signs of fetal distress can increase the risk of strokes and other ischemic injuries during delivery.
Birth Trauma
Traumatic brain injuries, often resulting from labor and delivery complications, are also a significant cause of hemiplegia. Cerebral lacerations (deep cuts within brain tissue), spinal cord lacerations (i.e., Brown-Séquard syndrome), and subdural hematomas can all lead to brain damage and the development of hemiplegia.
These injuries are often a result of excessive force or improper techniques used during the delivery process. Misusing delivery instruments like forceps or vacuum extractors can exert too much pressure on a newborn's head or neck. This is a common preventable cause of cerebral lacerations and spinal cord injuries that can result in paralysis.
Other common causes of birth trauma include C-section errors and applying fundal pressure in cases of shoulder dystocia.
Neonatal Infections
Infections affecting the nervous system can lead to hemiplegia by causing inflammation or damage to brain tissue. Several types of infections can contribute to this condition, including encephalitis, meningitis, and brain abscesses.
Encephalitis, for example, is an inflammation of the brain from viral infections such as herpes simplex virus or arboviruses. This condition can lead to widespread brain damage, impairing motor functions and potentially resulting in hemiplegia.
Delays in diagnosing these neonatal infections can allow them to progress into widespread bodily responses like neonatal sepsis. Untreated sepsis can cause significant brain damage and affect motor control, leading to cerebral palsy symptoms like hemiplegia.
In addition to infections, diseases of the central nervous system can also cause hemiplegia. Multiple sclerosis (MS) is a common disease that can have this effect.
Multiple Sclerosis involves the immune system attacking the nerve fiber protective covering, disrupting communication between the brain and the body. This disruption can cause weakness, loss of motor control, and other neurological symptoms like hemiplegia.
Premature Birth
Premature infants have underdeveloped brains and organs, making them particularly vulnerable to conditions like intraventricular hemorrhage (IVH). This is a form of brain bleeding that can cause permanent neurological damage, including symptoms of paralysis and muscle weakness.
Medical errors such as inadequate monitoring for maternal infections like chorioamnionitis significantly increase the risk of premature birth. Failing to address pregnancy complications like preeclampsia can also increase a mother’s risk for delivering early.
What Are the Signs of Hemiplegia?
Hemiplegia can manifest in various ways, with symptoms ranging from mild weakness to complete paralysis. Symptoms may present early in infancy or develop over time, often involving motor difficulties, developmental delays, and sensory impairments.
The primary symptom of hemiplegia is the loss of motor function on one side of the body. On the affected side of the body, a child may lose sensation completely or only partially.
In infants, seizures are often an early indicator of hemiplegic cerebral palsy, occurring in approximately 60% of cases. Children with hemiplegia may also show a preference for one hand and keep the affected hand coiled into a fist.
Other early signs of hemiplegia in infants may include:
- Asymmetrical movements while standing or crawling
- Having trouble swallowing or speaking, a common sign of cerebral palsy dysarthria
- One-sided muscle stiffness and spasticity
- Engaging in tasks requiring fine motor skills
- Failure to achieve typical developmental milestones such as rolling over, sitting upright, crawling, or walking
- Difficulty with balance and keeping control of the limbs on the affected side
Hemiplegia is not a progressive disease. Once the condition is present, it does not worsen over time. However, it can lead to secondary conditions linked to motor function impairments.
Children with hemiplegia may experience the following secondary conditions:
- Cardiovascular Issues: Limited physical activity due to reduced mobility and muscle weakness can contribute to cardiovascular problems.
- Attention and Concentration: Maintaining focus for extended periods may be challenging. The child might struggle to ignore distractions, especially in noisy environments like classrooms. They may have difficulty switching from one task to another.
- Reduced Flexibility and Mobility: The lack of mobility in muscles and joints can limit the child’s flexibility. This can make it difficult for them to perform everyday tasks.
- Vision Impairments: Problems with visual processing or eye movement coordination can lead to vision changes or reduced sensory perception on the affected side.
- Social Communication: Engaging in meaningful conversations requires a mix of cognitive, linguistic, and social abilities. The child may find it challenging to interpret social cues, organize thoughts, and follow appropriate social behaviors.
- Memory: The child may face challenges in learning, retaining, and recalling new information can affect daily activities and academic progress.
- Behavioral Issues: Emotional and behavioral changes are common, including irritability, mood swings, hyperactivity, apathy, or sudden outbursts.
- Epilepsy: Seizures can occur, either shortly after the injury or years later and may require ongoing management with medication.
- Speech Impairment: Children may experience speech difficulties, including slow speech development, difficulty articulating words, or difficulty forming complete sentences. When a child suffers a focal injury such as a stroke, they may have difficulty with expressive language (talking). They usually do not have issues with receptive language (understanding). Many children catch up with their peers around the age of 3 with speech therapy and other interventions.
If you notice any of these signs in your child, seeking medical advice promptly is important. Early intervention for movement conditions like hemiplegia can significantly improve outcomes.
How to Diagnose Hemiplegia?
Doctors typically base a child’s hemiplegia diagnosis primarily off a thorough review of their physical symptoms. However, they may take other factors into consideration to rule out any other possible conditions.
Medical professionals must review the child’s medical history for any notes that could cause symptoms similar to hemiplegia. They may conduct further testing with a complete blood count (CBC) test, neuroimaging, or diagnostic testing like electroencephalogram (EEGs).
When doctors evaluate brain injuries or spinal cord injuries, they most commonly use magnetic resonance imaging and computed tomography scans. This is because MRI and CT scans are relatively noninvasive for the baby and provide accurate and detailed images.
MRI scans and CT scans can detect potential causes of brain damage, including neonatal strokes, brain tumors, and aneurysms. An EEG measures the brain’s electrical activity and can reveal the part(s) of the brain from which neonatal seizures originate.
These neuroimaging scans provide valuable insight into the extent of a child’s brain or central nervous system damage. However, a definitive diagnosis of hemiplegia can only occur through a consultation with a licensed specialist.
This specialist may be a pediatric neurologist who specifically diagnoses brain and nervous system disorders. But a general practicing physician can also diagnose the movement disorder upon observing a child’s symptoms and interpreting scan results.
After receiving a diagnosis, children can work with their medical specialists and caregivers to begin planning treatment for their hemiplegia.
What Are the Treatment Options for Hemiplegia?
Treating hemiplegia requires a multidisciplinary approach with healthcare professionals across fields working together. This includes physicians, physical therapists, occupational therapists, and psychologists all collaborating to help affected children regain their functionality.
Doctors must tailor each treatment plan to the child by taking their age, overall health, and unique challenges into consideration.
Rehabilitation and Therapy
Rehabilitation is a crucial component of treating hemiplegia symptoms. Doctors will often recommend or prescribe a mix of physical, occupational, and speech therapies to address a range of challenges.
Physical Therapy
Physical therapy focuses on managing muscle stiffness, increasing range of motion, and enhancing coordination through targeted exercises and activities.
When repeated, these exercises can help children gradually develop strength, balance, and flexibility with their limited movement from hemiplegia. This can help them achieve more independence in daily tasks, giving them a greater sense of accomplishment and purpose.
Occupational Therapy
Occupational therapy helps children with hemiplegia improve their ability to perform everyday tasks, such as dressing, feeding, and personal hygiene.
The specific tasks the child practices will depend on their age and specific strengths and weaknesses. If their hemiplegia is especially affecting their arm, for example, the occupational therapist may focus on tasks involving that limb. They may help the child improve activities that typically require two hands, such as tying their shoes and changing clothes.
Like with physical therapy, occupational therapy can greatly improve a child’s sense of independence.
Speech Therapy
Hemiplegia sometimes affects a child’s communication or swallowing, leading to speech impairments and swallowing disorders. Children with weakened mouth and throat muscles may have dysarthria, a common cerebral palsy symptom resulting in slurred, slow speech.
Speech therapy can help children regain the ability to speak clearly, eat, and swallow safely. Exercises practicing tongue placement, articulation therapy, and guided language intervention activities can all improve the child’s speech.
Speech therapists can also help children use and make the best of alternative cerebral palsy communication devices. This technology may become the child’s next best method of communication when hemiplegia symptoms prevent the possibility of regaining speech.
Beyond these therapy options, medical professionals may sometimes employ more specialized forms of therapy. One option is neuromuscular electrical stimulation, a high-intensity electrical stimulator decreasing spasticity and increasing the child's awareness of their limbs.
The child’s healthcare provider will make the final determination on which combination of therapies will most effectively treat their hemiplegia.
Medications
Medications can play a role in managing symptoms like muscle spasticity or seizures.
- Muscle Relaxants and Botox Injections: can reduce muscle tightness, improve movement, and relieve the discomfort from spasticity. Muscle relaxants like Baclofen can reduce the transmission of nerve signals within the child’s spinal cord, which eases spasticity. Botox injections are one of the newest treatments for cerebral palsy, targeting the specific muscles affected by spasticity.
- Anticonvulsants: Medications like phenytoin may be prescribed to manage seizures arising from a brain injury and prevent additional complications.
- Antibiotics: Prescribed (i.e., meropenem and ampicillin) to treat brain infections like meningitis or encepholitis occurring as a result of the injury.
- Blood thinners: Medications like warfarin or heparin can help prevent blood clotting, reducing the risk of strokes and other complications.
While medication alone is not a cure, it works well alongside physical therapy and other treatments to combat hemiplegia symptoms.
Surgical Interventions
In cases where more conservative treatments prove ineffective, doctors may consider surgical interventions. Surgical operations can correct joint deformities, alleviate chronic spasticity, and improve range of motion in ways that other treatments cannot.
Selective Dorsal Rhizotomy
Selective Dorsal Rhizotomy targets specific nerves responsible for muscle spasticity, helping reduce the nerve activity that causes muscle tightness.
Children must be older than two and have a hemiplegia diagnosis from a licensed specialist to qualify for the procedure. Medical professionals will usually keep the child in the hospital for 2 to 5 days following the operation. They will then need intensive physical therapy in the months afterward to rebuild strength and prevent muscle atrophy.
Hip Muscle Release Surgery
Hip muscle release surgery is an orthopedic procedure where surgeons cut or lengthen the muscles and tendons in the hips. They do this to reduce stiffness or correct any deformities, alleviating the child’s pain and improving their range of motion.
Children with hemiplegia often have muscle imbalances in the hips on the affected side of their body. The procedure most commonly targets the Iliopsoas and Piriformis muscles.
The recovery for this procedure is similar to a selective dorsal rhizotomy. The child will usually stay in the hospital for up to one week for recovery. Afterward, their doctor will enroll them in physical therapy multiple times per week.
Osteotomy Surgery
Osteotomy is a surgery where a surgeon cuts and reshapes a bone to help it fit better into a joint. Children with hemiplegia sometimes have hip muscles that unevenly pull on the bones. This causes the bones to partially dislocate from the joint (known as subluxations).
The goal of an osteotomy is to relieve abnormal tension from tightened muscles and reduce the strain on the joints. When successful, the procedure can greatly improve the child’s ability to stand, walk, and move around.
A child’s recovery time will depend on the type of osteotomy they received (most commonly either femoral, pelvic, or tibial). For all types, the recovery process is long and typically requires wearing a spica cast from the hip down. The child will wear this cast for 4-8 weeks before starting physical therapy.
Surgical options are especially effective for addressing conditions secondary to hemiplegia. This includes complications such as muscle contractions, spinal injuries, or damage to ligaments and tendons. Surgery can also treat aneurysms and remove narrowed blood vessels within the brain.
Adaptive Equipment for Enhanced Mobility
Adaptive equipment plays an essential role in improving the mobility and overall quality of life of children with hemiplegia.
Tools such as orthotic braces, walkers, and wheelchairs can provide stability and promote independence. Additionally, adaptive devices, including splints and braces, may help with spasticity and gait (walking).
There are also certain specialized equipment types designed to encourage symmetrical movements for children with limited use of one side.
While there is no "cure" for hemiplegia, treatment generally focuses on addressing any underlying causes of the condition. The child may additionally need treatment for any associated conditions like recurrent seizures or other cerebral palsy symptoms.
Immediate treatment is not always necessary as some children may experience gradual improvement on their own. However, this usually isn’t the case when permanent damage like spinal cord injuries or traumatic brain injuries occur. When a child’s hemiplegia stems from a severe birth injury, they will typically undergo a combination of therapies and interventions.
Did Medical Errors Worsen My Child’s Cerebral Palsy Symptoms?
Cerebral palsy will likely affect every physical aspect of a child’s life. Conditions like hemiplegia can affect their everyday functioning and development, making it more difficult to achieve independence.
Treatments and therapies can be incredibly expensive and put families into difficult financial situations. Additionally, as children with this condition grow, their treatment needs may evolve and further exacerbate costs.
No family should have to make the incredibly painful choice between paying for everyday bills and expenses or life-altering treatment.
Families may be entitled to financial compensation when their child’s cerebral palsy diagnosis stemmed from medical mistakes.
Errors during birth, such as delaying an emergency C-section or prolonging oxygen deprivation at birth, can cause irreversible brain injuries. This brain damage at birth can result in movement disorders like hemiplegia during early childhood.
If a family believes medical negligence worsened a child’s brain damage at birth, legal support may be an option. A cerebral palsy attorney can review the medical records and circumstances to assess whether a claim exists.
Families who have experienced the effects of brain injuries from negligent medical care deserve to know whether they were avoidable. Our cerebral palsy attorneys specialize in birth injury medical malpractice, helping families seek compensation when negligence causes lifelong conditions.
Our team will thoroughly investigate the facts, holding responsible parties accountable by pursuing medical malpractice claims.
What is the Statute of Limitations in a Birth Injury Case?
A statute of limitations (SOL) is a law that sets a time limit on how long an injured person has to file a lawsuit after an accident. It is essential to understand that statutes of limitations vary based on the case and the state where you file. For instance, the deadline for birth injury claims is typically different from other claims, such as injury to private property.
Generally, the clock starts ticking on the date the injury occurred. However, there are exceptions to this rule. In some cases, the statute of limitations starts when a person discovers or reasonably should have discovered an injury. When dealing with government agencies, SOLs can become even more complex.
For example, if the party that injured you was:
- A federal employee
- Employed by a military hospital, Veterans Administration facility, or a federally funded medical entity
You may need to file a birth injury claim under the Federal Tort Claims Act (FTCA). In FTCA cases, claimants must go through certain administrative procedures before filing a lawsuit. In some states, you may have less time to give notice if:
- The negligent party was a local or state government hospital
- The doctors and medical providers are employees of a governmental entity
If you file your case outside of the statute of limitations, the court will typically dismiss it. This means you will not be eligible to recover compensation for you or your child’s injuries.
Determining when a statute of limitations begins on your case can be tricky. Our cerebral palsy attorneys specialize in birth injury medical malpractice and can tell you important cutoff dates in your state.
How Can Our Cerebral Palsy Attorneys Help?
Hemiplegia is just one of many cerebral palsy symptoms that obstructs a child’s way of living and moving. A child with cerebral palsy requires ongoing treatments and therapies estimated to exceed approximately $1 million over their lifetime.
If you believe their conditions are the result of medical negligence or malpractice, you may be able to recover compensation. This compensation can cover the cost of therapies, assistive equipment and devices, and other cerebral palsy-related expenses.
A detailed expert review of the facts and circumstances of your pregnancy and your child's birth can reveal many things. Namely, it can determine whether a child’s cerebral palsy diagnosis and related symptoms were the result of medical malpractice.
Our Process
Our team of cerebral palsy attorneys specializes in birth injury medical malpractice and can help assess your potential cerebral palsy case. We use our detailed medical negligence case review process to take in your information and begin learning more.
We start by gathering information about your pregnancy by examining records to determine what happened during and after your delivery. This includes evaluating the fetal heart rate strips during labor and any action medical professionals took in the NICU.
We will call in skilled medical experts who review your records and provide insight into where medical professionals went wrong. If we feel medical negligence caused or worsened your baby’s cerebral palsy symptoms, we meet with you to discuss further.
At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment once you do. The sooner you reach out, the sooner we can investigate your case and gather the evidence to support your claim.
We work on a contingency fee basis, meaning you will not pay any legal fees until we win your case. We do not purse any medical malpractice cases unless we fully believe we can win.
Contact us today to schedule your free consultation by calling our toll-free line at (888) 987-0005. You can also reach us by filling out our online request form.
Miller Weisbrod Olesky
At Miller Weisbrod Olesky, the attorneys, nurses, and staff understand that parents of children with birth injuries feel overwhelmed. So, every client has the attention and support of a team of trained, compassionate professionals. But we don’t just offer compassion.
We offer a process to help you discover whether your child’s birth injury, HIE, cerebral palsy or brain injury was caused by a medical error.
Call our offices today at 888.987.0005 for experienced assistance in a free consultation.
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