Hemiplegia
Hemiplegia is paralysis of one side of the body; it usually arises from unilateral lesions above the midcervical spinal cord.
History
Onset
The speed of onset of hemiplegia is useful when trying to determine the underlying aetiology. Sudden onset hemiplegia is usually due to a cerebrovascular event such as a TIA, infarct or intracerebral haemorrhage. Hemiplegia developing over minutes or hours after trauma can be due to an evolving extradural or subdural haemorrhage. Although a history of trauma is usually evident, chronic subdural haematomas in the elderly may result from tearing of bridging veins without apparent trauma. Subacute hemiplegia may also result as part of a spectrum of neurological deficits caused by demyelination from multiple sclerosis. Gradual onset of hemiplegia is usually due to a tumour, although a cerebral abscess or chronic subdural haemorrhage may pursue a similar time course.
