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PubMed2004

Alternating hemiplegia of childhood: presentation of two cases regarding the extent of variability.

Alternating hemiplegia of childhood is an episodic neurological disorder, the diagnosis of which is solely clinical. In this report, two patients with alternating hemiplegia, one as a representative of the classical picture and the other with unusual features, are presented by video display. Some clinical manifestations and the variability of symptoms are discussed with regard to their place in the diagnosis of the disease. (Published with videosequences).

Anticonvulsants↗
PubMed1992

Concerning the mechanism of recovery in stroke hemiplegia.

Two patients with pure motor hemiplegia were regaining strength in the affected limbs when a pure motor stroke developed on the opposite side. At the same time as the new hemiplegia appeared, the recovering side became re-paralyzed, suggesting that activity in the contralateral corticospinal tract had participated in the recovery process. Pathological studies were confirmatory. The literature pertaining to contralateral motor compensation is reviewed.

Aged↗
PubMed1992

[Alternating hemiplegia. Partial effectiveness of treatment with flunarizine].

A case of alternating hemiplegia in a young girl is presented. The partial benefits of treatment with a calcium antagonist Flunarizine in this patient and in those reported in literature are reviewed. The onset of the disease in this girl was at three months of age with several episodes that were diagnosed as seizures; afterwards she presented, besides, repeated attacks of hemiplegia involving both sides of her body in an alternating way each time with daily frequency and hours of days of duration accompanied of bad mood and irritability as well as autonomic disturbances, oculomotor abnormalities, acquired mental retardation and residual focal neurological abnormalities. After one year of treatment with a calcium-entry blocker: Flunarizine, there was a 30% reduction in the attacks frequency as well as in its severity and stop of the progression of mental retardation. So we report the consequence of precocious diagnosis and treatment of this not well known entity whose clinical signs resemble paroxistic vascular anomalies in the brainstem territory.

Child, Preschool↗
PubMed2005

Startle-induced seizures associated with infantile hemiplegia: implication of the supplementary motor area.

This case illustrates an uncommon form of symptomatic startle-induced epilepsy associated with infantile hemiplegia. Seizure semiology, neuroimaging and neurophysiological findings support involvement of the supplementary motor area in the generation of this seizure type. We present the case of an 11-year-old girl with an uncommon form of startle-induced seizures, illustrated on video-EEG, against the background of left infantile hemiplegia associated with extensive right hemispheric porencephaly but preserved cognitive functioning. The epileptic focus appears to be in the dorsolateral frontal lobe, with seizure semiology involving the supplementary motor cortex.

Child↗
PubMed2005

[Effects of functional electric stimulation on shoulder subluxation and upper limb motor function recovery of patients with hemiplegia resulting from stroke].

OBJECTIVE: To observe the effects of functional electric stimulation (FES) on shoulder subluxation and motor function recovery of the upper extremities of patients with hemiplegia resulting from stroke. METHODS: Forty-eight hemiplegic patients were randomly divided into two groups for treatment with FES and shoulder pads, respectively. The recovery of the patient's shoulder subluxation and movement function of upper extremities were evaluated 6 weeks after treatment and the effects of two therapies were compared. RESULTS: The shoulder subluxation and movement function of the upper extremities were improved after treatment with both therapies (P<0.01, and FES showed better effect (P<0.01). CONCLUSIONS: FES can improve shoulder subluxation and motor function of the upper extremities affected by hemiplegia resulting from stroke.

Electric Stimulation Therapy↗
PubMed2005

[Modified hemispherectomy for intractable epilepsy in patients with infantile hemiplegia].

OBJECTIVE: To explore the effectiveness of modified hemispherectomy for intractable epilepsy in patients with infantile hemiplegia. METHODS: Eighteen cases of patients were treated with modified hemispherectomy and the effectiveness was studied and followed up. RESULTS: The seizures in all 18 cases of patients were controlled effectively and stopped completely in 16 cases of them, without nervous disfunction worsened. The patients' cerebral peduncles on healthy side were much thicker than those on sick side (t = 58.32, P < 0.001) and healthy peoples' (t = 14.63, P < 0.001) and the patients' cerebral peduncles on sick side were much thinner than those of healthy peoples' (t = 51.27, P < 0.001). CONCLUSION: The modified hemispherectomy can effectively control the seizures of patients with infantile hemiplegia without superficial cerebral hemosiderosis happened.

Adolescent↗
PubMed2006

Effect of "phased whole acupuncture therapy" on ability of daily life in 63 cases of cerebral infarction-induced hemiplegia.

OBJECTIVE: To observe the effect of "phased whole acupuncture therapy" on the ability of daily life (ADL) of the patients with cerebral infarction-induced hemiplegia. METHODS: 113 patients were randomly divided into a treatment group (n=63) treated with phased whole acupuncture and a control group (n=50) treated with traditional acupuncture. After the treatment, the improvement of ADL was compared between the two groups. RESULTS: Patients in the treatment group obtained satisfactory therapeutic effects in ADL improvement and in lowering of deformed rate, which were superior to those in the control group. CONCLUSION: The phased whole acupuncture is an effective therapy in treating cerebral infarction-induced hemiplegia, which can better improve the life quality of the patients.

Activities of Daily Living↗
PubMed2006

[A new thinking of acupuncture and moxibustion treatment of shoulder pain after hemiplegia].

Analysis from anatomy and physiology indicates that causes of shoulder pain are (1) decline and after-constriction of the scapula;(2) the adduction and intorsion of the humerus; (3) the spasm of the upper limb flexor. The acupuncture and moxibustion prescriptions stipulated for prevention and treatment of shoulder pain are Jianjing (GB 21), Jianzhongshu (SI 15), Jugu (LI 16), Tianzong (SI 11), Jianliao (SJ 14), Jiquan (HT 1) at the flaccid hemiplegia, and Jugu (LI 16), Jianyu (LI 15), Tianzong (SI 11), Jianliao (SJ 14), Xiaoluo (SJ 12), Shanglian (LI 9), Wenliu (LI 7) at the spastic hemiplegia , in combination with cupping at the Urinary Bladder Meridian on the back and around shoulder. Thus, it is indicated that shoulder pain not only is involved in the shoulder joint but also in all muscle groups of the shoulder girdle and the upper limb extensor at the affected side.

Acupuncture Therapy↗
PubMed1991

[Post-vaccinal hemi-convulsion hemiplegia syndrome].

An 18-month-old infant developed hemiseizure-hemiplegia syndrome following a booster dose of vaccine against diphtheria, pertussis, tetanus, and poliomyelitis. Clinical, CT scan, and electroencephalographic findings during the two-and-a-half-year follow-up are described. The timing of events and data from the literature suggest that hemiseizure-hemiplegia syndrome is related to post-immunization hyperthermia rather than to direct neurologic toxicity of the vaccine.

Child, Preschool↗
PubMed1990

[Acute hemiplegia in childhood and alternating hemiconvulsions secondary to Moya-Moya disease. Report of a case associated with Down's syndrome].

Moya-Moya disease has been associated to a number of disease entities including Down syndrome. Initial clinical manifestations in our patient were alternating lateralizing seizures with sudden onset hemiparesis. Ct scan demonstrated several infarcts in different stages of evolution, in the territory of left middle cerebral artery. Single digital subtraction angiography showed bilateral occlusion, predominantly on the left side of the supraclinoid portion of the interna carotid arteries with formation of collateral circulation in the diencephalic territory. The association of Moya-Moya disease and Down syndrome is not fortuitous and it is probably due to a congenital vascular dysplasia. It should be suspected in children with trisomy 21 (with or without congenital heart disease) who presents with alternating hemiplegia and convulsions or acute hemiplegia.

Acute Disease↗
PubMed1990

[Hemiplegia: diagnosis and differential diagnosis].

Hemiplegia is the most frequent form of paralysis in humans and involves face, arm and leg on one side of the body. Diseases localized in the cortex, the cerebral white matter (corona radiata) and the internal capsule usually manifest themselves by weakness or paralysis of the face, the arm and the leg on the opposite side. In the causation of hemiplegia, vascular diseases of cerebrum and brainstem exceed all others in frequency. Trauma ranks second, and other important causes are brain tumor, encephalitis or abscess and demyelinating diseases.

Central Nervous System Diseases↗
PubMed1990

Hypoglycemic hemiplegia.

The usual signs and symptoms of hypoglycemia include tachycardia and profound diaphoresis. These will progress to include an altered mental status that can advance in severe cases to coma, seizures, and death. Occasionally, hypoglycemia may present with focal neurologic signs that can include hemiparesis or hemiplegia with preservation of mental status. In patients with the latter signs, the possibility of a cerebrovascular accident or other intracranial abnormality must be considered. The authors describe an elderly patient with hypoglycemic hemiplegia secondary to insulin administration. Their report includes observations on clinical presentation, the various mechanisms involved, and guidelines for the management of this syndrome.

Aged↗
PubMed1990

Failure of subtotal arytenoidectomy to improve upper airway flow mechanics in exercising standardbreds with induced laryngeal hemiplegia.

Upper airway flow mechanics and arterial blood gas measurements were used to assess the efficacy of subtotal arytenoidectomy for treatment of induced left laryngeal hemiplegia in horses. Measurements were collected with the horses at rest, and trotting or pacing on a treadmill (6.38 degrees incline) at speeds of 4.2 and 7.0 m/s. Experimental protocols were performed after right common carotid artery exteriorization (baseline), after left recurrent laryngeal neurectomy (LRLN), and after left subtotal arytenoidectomy. At baseline, increasing treadmill speed progressively increased peak inspiratory and expiratory flow (VImax and VEmax, respectively), peak inspiratory and expiratory transupper airway pressure (PuI and PuE, respectively), respiratory frequency (f), tidal volume (VT), minute volume (VE), and heart rate. Inspiratory and expiratory times (TI and TE, respectively) and arterial oxygen tension (PaO2) decreased with increased treadmill speed; inspiratory and expiratory impedance (ZI and ZE, respectively) did not change. After LRLN, VImax, f, and PaO2 significantly (P less than 0.05) decreased at exercise, whereas PuI, TI, and ZI significantly increased. Minute volume decreased at exercise after LRLN, but the changes were not significant; LRLN had no effect on VEmax, PuE, ZE, heart rate, arterial carbon dioxide tension (PaCO2), or VT. Subtotal arytenoidectomy did not improve upper airway flow mechanics or blood gas measurements impaired by laryngeal hemiplegia.

Animals↗
PubMed1989

Double disability of hemiplegia and hip disarticulation: rehabilitation outcome.

Double disability of hemiplegia and hip disarticulation is uncommon. To our knowledge, there are no reports of such patients and their rehabilitation outcomes. We report on a patient with hemiplegia and hip disarticulation who became independent in prosthetic ambulation and activities of daily living. Motivation, age, good neuromuscular status, and past successful prosthetic use favored the excellent rehabilitation outcome in this patient.

Adolescent↗
PubMed1988

[Alternating hemiplegia in childhood. Clinical report and single photon emission computed tomography study].

From 6 months of age on this girl experienced frequent episodes of hemiplegia involving both sides of the body and lasting up to 8 days. The attacks were often precipitated by tonic deviation of the head and/or the eyes to one side and nystagmus. At this stage the girl used to cry. Squinting, tonic stiffening of body and extremities, and dystonic posturing also occurred. Autonomic dysfunctions such as paleness of the skin, sweating, respiratory embarrassment, tachycardia, and mydriasis were associated features of the attacks. Motor and mental development of the girl is delayed. Improvement concerning severity, duration and frequency of the attacks has been achieved by permanent treatment with flunarizine in combination with acetazolamide and acetylsalicylic acid. If the child falls asleep immediately after rectal application of chloral hydrate at the onset of an attack there is no hemiplegia after awakening.

Acetazolamide↗
PubMed1988

Gait comparison of subjects with hemiplegia walking unbraced, with ankle-foot orthosis, and with Air-Stirrup brace.

The effects of the Air-Stirrup (AS) standard ankle brace on the gait of 19 subjects with hemiplegia resulting from a cerebrovascular accident who exhibited excessive subtalar joint motion were studied. Videotaped trials and footprint analyses were used to measure subjects' hip, knee, and ankle sagittal plane angles; inversion and eversion of the calcaneus; and time-distance gait characteristics. A one-way analysis of variance for repeated measures was used to compare the gait of 19 subjects with the AS brace and unbraced and 11 subjects with the AS brace, unbraced, and with an ankle-foot orthosis. The AS brace was associated with more calcaneal stability during standing than the unbraced condition. The ankle-foot orthosis was associated with less plantar flexion at foot-strike than either the AS brace or unbraced condition. Both the AS brace and the ankle-foot orthosis were associated with less mid-swing plantar flexion and increased step length on the paretic side compared with no brace. These results support the effectiveness of the AS brace in controlling inversion and eversion instability in patients with hemiplegia.

Ankle↗
PubMed1987

[Thromboembolism complications following acute hemiplegias].

143 patients with acute onset of hemiplegia transferred to our unit for rehabilitation were analysed retrospectively for the development of deep vein thrombosis or pulmonary emboli. 26% of the patients had suffered thromboembolic events, in more than half of the cases within the initial four weeks after hospital admission. Hemiplegia seems to be the main risk factor for thromboembolic complications, whereas age and sex had no further impact on the rate of occurrence in our series. Nor did we find a correlation between the extent of the paresis in the involved lower extremity or the degree of restriction of mobility and the incidence of thromboembolic disease. Because of the high frequency of thromboembolic complications in our patients we recommended prophylactic treatment with low dose heparin given subcutaneously, followed by oral anticoagulant therapy with vitamin K antagonists, provided there are no contraindications.

Adolescent↗
PubMed1987

Heterotopic ossification in hemiplegia following stroke.

Heterotopic ossification is a recognized complication in patients with head injury, burns, paraplegia, or direct trauma to muscle tissue. Heterotopic ossification with hemiplegia following stroke is considered rare. A case of a 53-year-old patient with right hemiplegia who developed painful right hip, limiting range of movement and progress in ambulation, is presented. X-ray and laboratory tests confirmed the presence of heterotopic ossification, suggesting that this condition may not be so rare in patients with a cerebrovascular accident, but may escape recognition, with pain being considered to stem from soft-tissue strain, premorbid arthritis, or altered sensation commonly associated with stroke.

Cerebrovascular Disorders↗