Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HEMIPLEGIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMedDate not supplied

Acute hemiplegia in childhood with the occlusion of the posterior cerebral artery.

Two cases of acute hemiplegia with the occlusion of the posterior cerebral artery were reported in children. Both patients were low-birth-weight infants with a history of febrile convulsions. Cerebral edema due to prolonged seizures was considered to be an etiologic factor of the occlusion of posterior cerebral artery. When the seizure is focal or the patient has perinatal difficulty, febrile convulsions should be treated carefully, as the possibility of epilepsy exists.

Brain Edema↗
PubMedDate not supplied

Computed tomographic changes in juvenile hemiplegia.

A retrospective analysis of the computer tomographic scans (CT) in 68 patients with juvenile hemiplegia was done. There was predominance of males (60%) over females, as well as left-sided lesions (57%). The CT findings were normal in 15% with atrophic changes in 34%, low attenuation areas of fluid density in 46% and 2.9% (two cases) with tumours. Typical areas of infarction following vascular injuries could be identified in 15% of cases. Six out of 8 calcifications were associated with tuberculoma of the brain. It is noted that cystic changes are the end-results of most infarctions, infections and other diseases within the brain. Therefore, CT as a diagnostic tool is efficacious in determining the anatomical site of lesion, but incapable of elucidating the aetiological basis of such a lesion.

Adolescent↗
PubMed1987

Emergency carotid artery thrombectomy for postpartum hemiplegia.

The case of a 22-year-old patient who suffered from postpartum hemiplegia due to thrombosis of the internal carotid artery is reported. She was treated aggressively with pentobarbital coma, angiography, and thrombectomy and recovered with minimal deficit.

Adult↗
PubMed1988

Improvement in grasp skill in children with hemiplegia with the MacKinnon splint.

This study evaluated the use of the MacKinnon splint upon grasp skills in three children, ages 2 1/2 to 7 1/2, with spastic hemiplegia. The MacKinnon splint was sequentially introduced in a multiple baseline design across subjects. The results indicated improvement in each child's grasp of eight different, randomly presented objects, after a MacKinnon splint was provided for daily wear.

Cerebral Palsy↗
PubMed2005

[Hemiplegia and a hiking tour of Mont Blanc: from hope to reality].

INTRODUCTION: At the end of an endurance training program for stroke patients with hemiplegia, we offered a hiking tour around the Mont Blanc Pedestrian Tour. We found no publication describing a similar experience and no scientific data in the literature to determine the physiological characteristics required for this performance, particularly regarding cardiac and vascular capacities, level of impairment, and functional abilities. OBJECTIVE: To complete a part of the Mont Blanc Pedestrian Tour over six days, with a group of adults with hemiparesis and aphasia due to stroke. POPULATION: Seven of 20 subjects with right hemiparesis and aphasia were selected on the basis of results of physiological tests, after an endurance training program and two tests hikes at medium altitude. Mean age was 51.71 +/- 7.13 years, mean VO(2max) 19.76 +/- 3.46 ml.g(-1).mm(-1), mean P(max) 90 +/- 22.68 and mean walking speed 3.60 +/- 1.30 km/hour. ORGANIZATION: Organization involved setting up the itinerary, recruiting accompanying personnel (9 people), and arranging security. No specific adaptations for accessibility were available, and no specific equipment was used, except for standard walking sticks. RESULTS: During this pedestrian tour, the subjects demonstrated strong motivation, as well as exceptional physical and functional performance, despite significant changes in elevation (up to 1500 m per day) and long walking times (from 5 to 9 hours per day). DISCUSSION: This experience has enriched our reflection about the medical, functional, and psychological conditions required for this type of physical effort, both from patients and accompanying personnel. In the absence of reports on similar experiences with this patient population, we thought it interesting, six months after this challenge, to present our observations as well as the patients' point of view. This may encourage other rehabilitation teams to offer intensive walking activities for stroke patients.

Aphasia↗
PubMed2004

Upper-extremity interlimb coupling in persons with left hemiplegia due to stroke.

OBJECTIVE: To investigate interlimb coupling in an adult population with left hemiplegia and an age-matched control group to better understand the unique motor control issues in stroke rehabilitation. DESIGN: A chi-square analysis was performed to compare the distribution of participants adopting a given movement pattern ratio during 2 different bimanual movement tasks for both groups. The task involved oscillating the upper limbs at the elbow in asymmetric patterns, with 1 limb oscillating at twice the frequency of the other. SETTING: Testing was done in the subjects' residences or in an outpatient clinic. PARTICIPANTS: Participants were between the ages of 45 and 75 years (mean +/- standard deviation, 63+/-9.4y), right handed, and included 18 left hemiparetic and 18 control subjects. Selection criteria for the hemiparetic group included status after nonhemorrhagic stroke within the distribution area of the right middle cerebral artery (RMCA). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Relative phase of the upper extremities. RESULTS: The hemiplegic group produced predominantly an in-phase 1-to-1 movement pattern, whereas the control group exhibited antiphase, 2-to-1 movement harmonics and, to a lesser extent, in-phase movement patterns. CONCLUSIONS: This study suggests that brain damage caused by stroke in the RMCA distribution area results in the reduction of selectable interlimb movement patterns. Specifically, bimanual upper extremity movement tended to be highly coupled in an in-phase movement pattern. Research is needed to examine the ability of stroke survivors to learn bilateral upper-extremity tasks at less stable levels of interlimb coupling.

Aged↗
PubMed2005

Kinematic effects on gait of a newly designed ankle-foot orthosis with oil damper resistance: a case series of 2 patients with hemiplegia.

The ankle joint of ankle-foot orthoses (AFOs) should restrict plantarflexion to prevent foot drop during the swing phase. However, excessive plantarflexion resistance causes excessive knee flexion during the stance phase. Plantarflexion resistive moment should be easily adjustable according to the gait ability of patients with hemiplegia. Because it is difficult to adjust plantarflexion resistive moment exactly, we developed an AFO with an oil damper. It is a small shock absorber that utilizes hydraulic resistance. The oil damper generates a resistive moment to the plantarflexion rotation of the ankle joint at the initial stance phase. The magnitude of the plantarflexion resistive moment at the heel strike can be easily adjusted to accommodate each patient's condition by simply turning an adjustment screw. We used a gait analysis system to compare the gait of 2 hemiplegic patients while they were wearing either the AFO with the oil damper or the AFO with the plantarflexion stop. The AFO with the oil damper achieved sufficient plantarflexion of the ankle and mild flexion of the knee by adjusting a proper plantarflexion resistive moment during initial stance phase, and provided a more comfortable gait than did the AFOs with a plantarflexion stop.

Ankle↗
PubMed2006

Hemiconvulsion-hemiplegia-epilepsy syndrome: early magnetic resonance imaging findings and neuroradiological follow-up.

We describe a case of hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome documented by longitudinal magnetic resonance imaging (MRI). A two-year and nine-month-old boy had a prolonged hemiconvulsion during fever followed by right hemiparesis. Seven days later the imaging abnormality on T2 and diffusion-weighted images (DWI) was limited to the white matter of the left hemisphere. One month later severe gliosis and unilateral brain atrophy were already evident. MRI is useful in the early stages of prolonged seizures and T2 and DWI abnormalities appear to be well correlated with parenchymal damage that results from sustained ictal activity. The neuroradiological findings in our case and in the few HHE patients reported in the literature seem to be very characteristic and, if confirmed in larger series, could permit an early diagnosis.

Child, Preschool↗
PubMed2004

Sudden onset aphasic hemiplegia: an unusual manifestation of disseminated encephalomyelitis.

The association of the sudden onset of aphasia with hemiplegia, hemisenosry defect, and facial palsy, with MRI evidence of white matter lesions, requires differentiation between multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM). We have observed eight patients with such a syndrome, all of whom were originally diagnosed as multiple sclerosis, but who, on closer examination, turned out to be instances of disseminated encephalomyelitis. The patterns of demyelination seen in T2-weighted MRI are quite different in both conditions. In two of our patients, MRI reverted to normal after the treatment; in others, the images remained unchanged. A review of the reported cases of multiple sclerosis presenting with the acute onset of aphasia, reveals that the majority of them are, in reality, instances of acute disseminated encephalomyelitis with a much better prognosis. Most of these cases are monophasic and immunomodulatory treatment is inappropriate.

Adolescent↗
PubMed2006

How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study.

Several studies indicated that walking with an ankle foot orthosis (AFO) impaired third rocker. The purpose of this study was to evaluate the effects of two types of orthoses, with similar goal settings, on gait, in a homogeneous group of children, using both barefoot and shoe walking as control conditions. Fifteen children with hemiplegia, aged between 4 and 10 years, received two types of individually tuned AFOs: common posterior leaf-spring (PLS) and Dual Carbon Fiber Spring AFO (CFO) (with carbon fibre at the dorsal part of the orthosis). Both orthoses were expected to prevent plantar flexion, thus improving first rocker, allowing dorsiflexion to improve second rocker, absorbing energy during second rocker, and returning it during the third rocker. The effect of the AFOs was studied using objective gait analysis, including 3D kinematics, and kinetics in four conditions: barefoot, shoes without AFO, and PLS and CFO combined with shoes. Several gait parameters significantly changed in shoe walking compared to barefoot walking (cadence, ankle ROM and velocity, knee shock absorption, and knee angle in swing). The CFO produced a significantly larger ankle ROM and ankle velocity during push-off, and an increased plantar flexion moment and power generation at pre-swing compared to the PLS (<0.01). The results of this study further support the findings of previous studies indicating that orthoses improve specific gait parameters compared to barefoot walking (velocity, step length, first and second ankle rocker, sagittal knee and hip ROM). However, compared to shoes, not all improvements were statistically significant.

Ankle↗
PubMed2002

Bilateral facilitation of motor control in chronic hemiplegia.

The present study addressed the efficacy of concurrently moving both arms, with and without a load added to the uninvolved arm, in facilitating the quality of movement of the involved side in individuals with moderate, chronic hemiplegia. Six hemiplegic cerebrovascular accident (CVA) subjects with left-hemisphere lesions participated in the study. The four males and two females ranged from 46 to 77 years of age and 30-96 months post-CVA. All subjects scored at least 70% on the Fugl-Meyer test of motor function. The task was to perform discrete unilateral and bilateral elbow extensions in the horizontal plane. The movements were 45 degrees in amplitude and were to terminate in a 10 degrees target zone that was indicated by an illustration of a coffee mug. The instructions were to move toward the mug as smoothly as possible in a movement time (MT) determined to be 20% longer than their minimal MT for that distance. The primary dependent variable was the percentage of continuous vs. discontinuous trajectories observed in each condition, based on whether or not a transient hesitation or reversal was observed. Phase of peak velocity was also quantified as a general indication of the symmetry of the velocity profile. Three of the six subjects exhibited a greater percentage of continuous movements of the involved arm in the nonloaded bilateral condition than the unimanual condition. Five subjects benefited when the uninvolved arm was inertially loaded in the bilateral condition when compared with unimanual performance. Only the oldest subject failed to exhibit facilitation. Peak velocity phase tended to normalize toward symmetry in the bilateral conditions. These findings are consistent with prior evidence that the control of the involved arm improves during bimanual performance for some hemiplegic subjects. It further suggests loading the uninvolved arm may benefit some subjects with respect to unimanual performance, with age perhaps playing a role in determining efficacy.

Aged↗
PubMed2003

Improvement in walking speed in poststroke spastic hemiplegia after intrathecal baclofen therapy: a preliminary study.

OBJECTIVE: To explore whether intrathecal baclofen (ITB) therapy improves ambulation in stroke survivors. DESIGN: Case series. SETTING: Tertiary care center. PARTICIPANTS: Ten adults with poststroke hemiparesis who were ambulatory at the time of pump implantation. INTERVENTIONS: Implantation of ITB pump after inadequate control of spasticity with other interventions. Time from stroke onset to implantation averaged 28.6 months (range, 9-55mo). MAIN OUTCOME MEASURES: Customary walking speed was measured from the time required to walk 50ft (15m) at a self-selected pace. Evaluators rated spastic hypertonia and functional mobility. RESULTS: Statistically significant improvements occurred in walking speed, functional mobility ratings, and spasticity (P<.05) at a follow-up interval that averaged 8.9 months. Mean walking speed over 50ft improved from 36.6 to 52cm/s. Mean Modified Ashworth Scale scores in the muscles of the affected lower limb improved from 2.0 to 0.4. Normal muscle strength (5/5) was preserved in the unaffected limbs. CONCLUSIONS: This preliminary study suggests that ITB therapy, in combination with physical therapy, may improve walking speed and functional mobility in ambulatory individuals with poststroke spastic hemiplegia.

Adult↗
PubMed1996

Peroneal stimulator; evaluation for the correction of spastic drop foot in hemiplegia.

OBJECTIVE: The objective of the study was to assess the orthotic and therapeutic value of the peroneal stimulator (PS) for adult hemiplegic patients. DESIGN: This was a two-period crossover study lasting 11 weeks. After recruitment each patient had a 4-week control period followed by a 4-week treatment period. The patients were assessed before the control period, after the control period, and after the treatment period. SETTING: Nineteen patients were recruited from physiotherapy departments in the Glasgow area; 2 subsequently dropped out before the treatment period. PATIENTS: All patients had hemiplegia as a result of cerebrovascular accident (CVA) and were greater than 3 months but less than 36 months post-CVA. Average time since stroke was 7 months. MAIN OUTCOME MEASURES: The patients' gait was assessed over smooth linoleum, carpet, and uneven ground. Gait was evaluated using a switch-based portable system. Outcome measures were the temporal gait parameters of speed, symmetry, heel strike, and foot inversion during stance. The gait evaluation was repeated on 5 separate days at each assessment. The Barthel Index was applied to each session. RESULTS: There was a significant orthotic improvement in inversion on all surfaces and for symmetry on linoleum (AN-OVA, p = .05). There was no significant improvement in patients' gait when not using the PS. There was a significant improvement in the Barthel Index over the treatment period (Wilcoxon, p = .05). CONCLUSION: Use of the PS an an orthotic device late in the rehabilitation program would be appropriate for a selected subpopulation of patients.

Adaptation, Physiological↗
PubMed1994

Effect of hemiplegia on skeletal maturation.

Children with cerebral palsy have been reported to have poor growth and delayed skeletal maturation, but it is unclear whether these effects are related to the underlying brain injury or to concomitant malnutrition. This study was designed to evaluate the effects of hemiplegic cerebral palsy on skeletal maturation and growth, with the unaffected side used as each subject's control. Bilateral hand-wrist radiographs were obtained for 19 children with spastic hemiplegia. Skeletal maturation was determined in a blinded fashion with the Fels method. The skeletal age of the affected (hemiplegic) side was less than that of the unaffected (control) side in all 19 subjects; the mean difference in skeletal age was 7.3 months (p < 0.001). The delay in skeletal maturation of the affected side correlated linearly with age and upper extremity function. These findings show that brain injury results in delayed skeletal maturation independent of malnutrition. This effect on skeletal maturation may explain, in part, the reason that some children with cerebral palsy grow poorly.

Adolescent↗
PubMedDate not supplied

[Prevention of deep venous thrombosis of the leg by a very low molecular weight heparin fraction (CY 222) in patients with hemiplegia following cerebral infarction: a randomized pilot study (30 patients)].

The effectiveness and safety of a very low molecular weight heparin fraction were evaluated in the prevention of deep-vein thrombosis in patients confined to bed due to hemiplegia consecutive to a recent cerebral infarction. CY 222 was administered within 48 hours of the stroke by one single daily subcutaneous injection of 0.6 ml (= 15,000 U AXa IC) during 14 days. This randomized pilot study involved 30 patients. The effects of CY 222 were assessed in a group of 15 patients compared with a control group of 15 untreated patients. No deep-vein thrombosis was detected by the labelled fibrinogen test in the treated group, as against 12 patients in the control group. Six patients (3 in each group) died during the study. One case of lethal pulmonary embolism was observed and confirmed at autopsy in the control group. In the remaining 5 patients, no systematic autopsy which would have asserted the absence of pulmonary embolism or drug-induced haemorrhage was performed. Numerous standard laboratory tests confirmed that CY 222 was well tolerated.

Aged↗
PubMed1997

Hemiplegia caused by inadvertent intra-carotid infusion of total parenteral nutrition.

A 24 year-old woman developed acute hemiplegia and a seizure following accidental catheterization of the right common carotid artery and total parenteral nutrition infusion. Magnetic resonance imaging of the brain showed lesions in the frontal lobe and putamen consistent with an ischemic stroke. Angiography through the central venous catheter confirmed its intra-arterial location. The patient's weakness improved after hyperbaric oxygen treatment. We concluded that stroke or seizures during total parenteral nutrition administration through a central venous catheter should alert one to the possibility of inadvertent intra-arterial infusion, especially in patients who have had central lines inserted several times previously.

Adult↗
PubMed1985

Surgery to achieve dynamic motor balance in adult acquired spastic hemiplegia: a preliminary report.

Reconstructive surgery of the upper limb was performed in an attempt to restore dynamic motor balance in 55 patients with adult-acquired spastic hemiplegia. An eight-level grading system was developed to determine the level of functional capacity. Because this system proved useful in predicting the results of surgery, it was utilized for operative planning. A two-level increase in functional grade was necessary for patients to obtain a meaningful increase in function. The average improvement after surgery was 2.10 functional levels. A two-level increase was achieved in 73.2% of the patients. No patient decreased in grade, and only one remained unchanged. In selected patients with upper limb spasticity, a predictable improvement in functional capacity can be obtained with dynamic motor balancing surgery.

Adolescent↗
PubMed2001

Long-term effect of flunarizine on patients with alternating hemiplegia of childhood in Japan.

To determine the effect of flunarizine therapy on patients with alternating hemiplegia of childhood (AHC), we sent a questionnaire by mail to council members of the Japanese Society of Child Neurology. We collected 28 AHC patients, and studied their clinical courses and the effects of drug therapy. All of the patients had received flunarizine. In 18 of the 28 patients, flunarizine reduced the severity, duration, or frequency of the hemiplegic attacks. No other drug was more effective than flunarizine. Some flunarizine non-effective patients were severely deteriorated, for example, they had dementia or were ventilator-assisted. Flunarizine had not only a short-term effect, i.e. it reduced the hemiplegic attacks, but also a long-term effect on the motor and intellectual development in some patients with AHC. Flunarizine is still an essential drug for treating AHC.

Adolescent↗