Hemiparesis: Symptoms, Causes, Treatment, Cost, and Side Effects

Hemiparesis, often referred to as unilateral paresis, is a common result of congenital conditions, injuries, tumors, or strokes that results in weakness on one side of the body (hemi- means 'half'). Your mobility may be restricted by this one-sided weakness, which may also have an impact on your ability to do everyday activity such as getting dressed, eating, and walking.

Hemiplegia and hemiparesis are frequently misunderstood. Though the same medical factors contribute to both the illnesses, the former causes one-sided complete paralysis which could make moving difficult or impossible. Hemiplegia can make it difficult to breathe, speak, swallow, or regulate one's bladder. Whereas, hemiparesis is weakening of one side of the body, which can have some movement and sensation left, however the patient might find it difficult to use that part of his body.

Depending on which side of the brain was affected during stroke, it's common to have weakness or paralysis on the opposite side of the body. The hemiparetic side of the body may be ipsilateral (the side of the brain injury) or contralateral (opposite the side of the brain injury).

If the left side of the brain, which is responsible for language and memory, has suffered damage, it will result in right-sided weakness or paralysis. A lesion to the right side of the brain, which houses the regions responsible for controlling facial recognition and nonverbal behavior, results in weakness or paralysis on the left side of the body.

Hemiparesis, which commonly affects your limbs and face muscles, happens when one side of the body is weaker than the other. Patients may have restricted movement in their arms, hands, legs, or facial muscles, which can make daily tasks more challenging.

Patients may have the following symptoms when they have a one-sided weakness in their arms, hands, face, chest, legs, or feet;

• Loss of balance
• Walking becomes challenging
• Grasping/holding objects becomes challenging
• Loss of spatial awareness
• Reduction in movement accuracy
• Muscle fatigue
• Loss of coordination

When someone experiences a brain stroke, which can be brought on by various reasons be it hemorrhage, obstruction or any injury to the central nervous system, blood supply to a certain part of the brain can be affected that may result in hemiparesis. As all our bodily movements are monitored and carried out by our central nervous system, due to this cell damage, many bodily functions are impacted and body parts controlled by that affected region get weak, a condition also known as hemiparesis.

As hemiparesis is a condition brought on by a stroke or injury, avoiding the cause altogether can prevent hemiparesis. To prevent half body weakness, one can adapt to a healthy and active lifestyle along with a medical team to manage any illnesses that increase the risk for stroke.

Here are some lifestyle modifications that can help you lessen your risk of stroke, hence of countering a hemiparesis;

Healthy eating
Consume a lot of fresh vegetables and fruits. Eating meals low in sodium (salt) can help lower blood pressure levels, thus further depleting your chances of experiencing a brain stroke.

Healthy weight
Obesity or being overweight raises your risk of brain stroke due to elevated levels of blood pressure and other lifestyle diseases. To avoid such unpleasant events keep a check on your body mass index (BMI) by taking the help of a health professional.

Regular exercise
With physical activity you not just shed extra kilos but your overall health improves with lower levels of blood pressure. It is often advised by the doctors to engage in 2 hours and 30 minutes of weekly moderate-intensity aerobic exercise, such as a brisk stroll.

Meditation/Yoga
Yoga and meditation can help you stay calm and may also bring down your high blood pressure that may reduce your chances of developing a stroke.

Manage your health conditions
Consult your doctor about the best ways to reduce your risk of having a brain stroke. You can take measures to lessen your risk of stroke if you have high blood pressure, aneurysm, or arteriovenous malformation (AVM) or any such underlying condition.

Avoid smoking
Smoking raises your risk of having a brain stroke. Stop smoking to reduce your risk of having a hemiparesis by stroke.

Cut down on alcohol
Avoid consuming excessive alcohol because it can make your blood pressure go up. Men should not exceed their daily alcohol intake from two drinks, while for women the safe limit is one.

No stress
Stress can raise your blood pressure to dangerous levels and result in a brain stroke. To avoid hemiparesis try calming exercises like meditation, yoga etc.

Clinical evaluation by a medical practitioner, such as a physiotherapist or doctor, identifies hemiparesis. The healthcare professionals can run several tests to look for the damage in the brain and issues with the movement in body parts to assess the condition deeply and chalk out an effective treatment plan.

The majority of the time, a doctor will employ a variety of diagnostic techniques and imaging tests to identify hemiparesis and hemiplegia, which might include;

• Electromyography (EMG)
• Complete blood count (CBC)
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Myelography
• X-ray

The healthcare provider may also do some physical tests to evaluate patient’s muscle weakness and the impact;

• The Fugl-Meyer Assessment of sensorimotor function (FMA): Following a cerebrovascular accident, the FMA is frequently employed as a measure of functional or physical impairment. It assesses pain, range of motion, sensory and motor dysfunction in the upper and lower extremities, as well as balance in various positions.
• The Chedoke-McMaster Stroke Assessment (CMSA): This test provides a valid assessment of two distinct factors assessing both motor impairment and disability. The disability component evaluates any changes in physical function, including walking ability and gross motor function.
• The Stroke Rehabilitation Assessment of Movement (STREAM): The STREAM includes 30 test items that assess fundamental mobility, lower-limb movements, and upper- and upper-limb motions. It is a clinical evaluation of post-stroke rolling, standing, bridging, stepping, walking, sit-to-stand, and stair climbing abilities.

Hemiparesis is a weakness of one side of the body after suffering a brain hemorrhage, trauma, injury or stroke. The patients may exhibit weakness in their arms, hands, face, chest, legs, or feet due to the hemiparesis.

If the patient experiences loss of balance, difficulty in walking, grasping/holding objects, loss of spatial awareness, reduction in movement accuracy, muscle fatigueness, loss of coordination take him to a medical expert.

Hemiparesis is a serious condition and if you notice yourself or your loved one showing symptoms, always contact a healthcare professional for the help.

Hemiparesis can be extremely exhausting for the patient both physically and psychologically. Because of the illness, the patient may find it very difficult to do daily activities, making them dependent on others. To help the patient recover well and fast, there are several natural home remedies that might assist manage hemiparesis;

Dietary modifications for hemiparesis:

• Always eat fresh food that is warm.
• Avoid cold and stale food.
• Avoid foods that are bitter, acidic, or pungent.
• Include foods that are sweet, sour, and salty.
• Nuts are very good options to include in your daily diet.
• While it is ok to consume rice and wheat in your diet, avoid barley, millet, and rye.
• While having meat, choose white meat and avoid red meats.
• Consume sizable portions of carrot, beetroot, okra, and asparagus as a part of your daily diet.

Home remedies for hemiparesis:

• Apply freshly cleaned and ground asparagus (genus) leaves to the affected region to relieve pain or discomfort.
• To reduce inflammation and pain, sauté a few drumstick leaves in castor oil and apply to the sore area.
• If you have weak facial muscles as a result of hemiparesis, mix equal quantities of black pepper powder and dry ginger powder with honey and consume it twice or thrice daily.
• Take 20–40 cc of radish oil twice daily to aid in the recovery.
• Make a fine paste of the akarkara root and combine it with the mahua (honey tree/butter tree) oil. Twice or three times per day, massage the afflicted area.
• The enzyme bromelain, which may be found in pineapple juice and stem, aids in pain relief. Three times per day, taking a 1500 mg tablet of bromelain can help with the pain.
• Consume 180–240 g of gingko every day. This reduces the risk of having another stroke attack.
• One teaspoon of flaxseed oil daily is also beneficial to manage pain.
• Dose of 3000 mg of vitamin C daily is also beneficial for hemiparesis patients.

Even though the aforementioned home remedies are highly helpful in treating and managing the symptoms of hemiparesis, it is always advised to take your doctor’s advice.

As all the cases are unique it depends on many factors such as age, health, damage to the brain cells, timely treatment among many others, if hemiparesis can go away on its own. However, there are some physical, occupational and speech therapies that can manage the symptoms of hemiparesis with the help of exercises, adaptive and assistive devices to improve function.

Food not just gives you energy to perform day-to-day life but its nutrients are helpful in your recovery. If you have had a stroke chances of getting another one also increases that can be also lessened by the right choice of food.

Hemiparesis patients often find it difficult to eat due to weak muscles. They may choke, cough, or gag, and in some instances liquid comes out of their nose due to difficulty in swallowing. However, it normally gets better with time, but the hemiparesis patients are advised to eat certain type of food during their initial recovery;

Eat soft foods only
It's easy to swallow soft food such as prepared cereal, mashed potatoes, soup, cottage cheese, and applesauce for hemiparesis patients. To make foods simpler to chew for them, you can cut it or shred into small pieces or pulse them in a blender.

Make your liquids thicker
To prevent dehydration, it's crucial to consume enough liquids. However, water and other thin liquids may enter the incorrect pipe. If you want to thicken your beverages, try using tapioca, matzo meal, cornstarch, banana or potato flakes, but see your doctor beforehand.
Here are some food choices that can help you gain strength to undergo strenuous physical exercises and physiotherapies;

Vegetables
Select nutrient-rich dark green and orange vegetables, and keep in mind to consume dried beans and peas on a regular basis.

Fruits
Consume a variety of fresh, frozen, or dried fruits on a regular basis.

Dairy
Select low-fat or fat-free dairy products, as well as a variety of calcium-rich non-dairy meals, on a daily basis.

Protein
Protein is very important to help strengthen your weak muscles. Pick low-fat or lean meats and poultry, and don't forget to mix it up with more sources of beans, peas, nuts, seeds, and fish. Make fish, nuts, and vegetable oils the primary sources of your daily fat intake.

Many hemiparesis patients complain of loss of appetite, hence it is very important to watch the nutrient value of their meal. Look out for more natural, fresh and nutrient pack foods and no the followings, that may include;

• Processed food
• Fast food
• Beverages that have a high level of caffeine
• Sugary drinks and food items
• Spicy and deep fry foods
• Any alcoholic beverage

As they all are low in nutrient value, eating them can lower your daily recommended intake of nutrients, which will have a negative impact on your recovery.

After a stroke is managed, the patients often require physiotherapy, speech therapy, and occupational therapy as a part of their rehabilitation programme.

Here is what each therapy targets at, and helps recover the patient from hemiparesis;

Speech therapy

It aids those who have difficulty speaking or understanding what they are saying. In this exercise the therapist helps the patient to do various tongue exercises to strengthen their tongue muscles and also makes them say vowels and consonants in many variations louder to strengthen their throat muscles and make their voice clear.

Physiotherapy

Exercises are used to help you regain any lost coordination and movement abilities following a stroke. There are various physical and mental exercises for brain stroke patients that may help them with recovery;

• Bilateral Arm Training
• Cardiorespiratory Training
• Community Walking
• Electrical Stimulation
• Electromechanical Assisted
• Electrotherapy
• Fatigue Management
• Gait & Mobility
• Hydrotherapy
• Mental Practice
• Mirror Therapy
• Mobilization Balance
• Orthotics
• Overground Walking
• Positioning
• Rhythmic Cueing
• Sitting
• Spasticity Management
• Splinting
• Standing
• Strength Training
• Stretch
• Treadmill Training
• Upper Limb
• Virtual Reality

Occupational Therapy

The goal of occupational therapy is to make daily tasks like eating, drinking, dressing, bathing, reading, and writing easier for the patient. This therapy can be used to make up for a side of the body that has been weakened. You could pick up ways and methods for handling typical and useful tasks.

Following a stroke, therapy and medication may be used to treat depression or other mental health disorders. You can contact Pristyn care to get expert assistance for your faster overall recovery.

As many studies have shown the recovery is faster in the first few months after the stroke and may slow down with time. Hence, to get the timely treatment is very important for the hemiparesis patients. Thus we recommend you to get medical help as soon as possible for your safer and faster recovery.

Hemipareis is the condition after a brain stroke that weakens half of the body due to the damage to brain cells. Due to the involvement of the brain, the patient may suffer damage to cognitive, motor, language, emotions, memory and many other faculties of his brain that may impair his abilities to even walk, talk, feel, see, swallow etc. These functions can be once again restored or improved with the help of various medical experts including;

• Speech Therapist
• Physiotherapist
• Neurologist
• Psychiatrist
• Occupational Therapist

Tissue plasminogen activator (tPA)
It is a thrombolytic and is known to improve the chances of recovering from a brain stroke. Stroke patients often receive tPA to help in their complete recovery. As per a study, patients who were given tPA, had shown less disability than patients who do not receive the drug.

Heparin
This anticoagulant is used to treat pulmonary embolism, arterial embolism, and deep vein thrombosis in brain stroke patients and is used to reduce the chances of another stroke.

Warfarin
An anticoagulant called warfarin is recommended for conditions like pulmonary embolism and deep vein thrombosis and helps in prevention of another stroke by dissolving any blood clots.

Hemiparesis needs to be treated with the help of therapies, physical and mental exercises and proper diet. Here are some of the widely used methods to treat the weakness of the muscles in hemiparesis patients;

Range-of-Motion Exercises
These exercises train the weaker or paralyzed limb to help prevent muscle rigidity and contractures. Range-of-motion exercises can be passive (assistance based exercises), active-assistive (assisted but self-engaged exercises), or active (patient motivated exercises) depending on whether the limb can move voluntarily or needs to be moved by someone else.

Flexibility Training
Your therapist will collaborate with you to develop the most effective stretching regimen for you, following a brain stroke. Flexibility exercises boost blood flow and can assist you in regaining your balance and coordination after a stroke. It can enhance posture and capability when combined with strength training.

Electrical Stimulation
In patients with hemiparesis, electrical stimulation has been utilized to enhance range of motion and strengthen arm muscles. Small electrical pads are applied to the arm's weak muscles during electrical stimulation. While you try to move your arm, a tiny electrical charge will induce a shock to the muscles, causing them to contract.

Modified Constraint-Induced Therapy (mCIT)
Focus exercises are used by therapists during mCIT to promote movement in individuals with hemiparetic arms. Over the course of a 10-week period, patients attend this therapy three times per week for half-hour sessions. According to research, mCIT can help improve the range of motion in a hemiparetic arm.

Motor Imagery (MI)
You'll be asked to visualize using a certain body part while completing motor-imagery activities. Certain sections of your brain and muscles might be active as if you were actually performing the activity as you visualize these bodily parts moving. Motor-imagination exercises may be helpful in assisting patients with walking, according to study, and have been proven to improve arm mobility in hemiparesis patients.

Assistive Devices
Patients with weak or paralyzed limbs can benefit from using wheelchairs, canes, walkers, and other assistive equipment to increase their strength and mobility. The device that best suits your needs will be suggested by your physical therapist, but it's crucial to be instructed on the safety precautions and appropriate usage of orthotics, including ensuring the device is fitted properly and learning how to maintain it.

Mental Imagery
Movement and mental visualization both stimulate the same overlapping parts of the brain. This could imply that if someone imagines moving the portion of their body that is weak, it may engage the muscles and parts of their brain that they would utilize if they were actually doing the activity.

People with hemiparesis may benefit from combining mental imagery with other therapy to reduce disability and increase use of their upper extremities.

If the patient experiences subsequent contracture problems as a result of a significant muscular activity imbalance, surgery might be necessary.

The surgeon may cut the ligaments in certain circumstances to ease joint contractures. A tube may be put into the stomach of people who are unable to swallow. This makes it possible to feed someone right into their stomach. Low doses of the liquid food are administered.

Some hemiparesis patients will benefit from using a prosthetic device of some kind. A variety of braces and splints are offered to stabilize a joint, help with walking, and maintain an upright posture.

Hemiparesis is a treatable condition and can be managed with the help of several experts such as speech therapist, physiotherapist, occupational therapist, neurologist and psychiatrist among many others. Hence, the cost of the treatment also varies as per the patients special requirements and the choice of your healthcare provider and other factors.

Recovery time can vary for every hemiparesis patient as they all are unique and can have different problems and conditions depending on their affected brain region. For someone it may take weeks, months, or even years. While some patients fully recover, others have long-term or permanent disability.

Typically, 3 months after the stroke recovery is very fast as the brain rewires and makes new pathways to compensate for the cell damage, hence exercise and therapies are very important during this phase. For these repetitive exercises neural pathways are created, strengthened and developed in the brain. Following this 3 month fast recovery window comes a state of ‘plateau’ during which the recovery becomes very slow and almost stagnant for many hemiparesis patients.

The mobility is very important for the hemiparesis patients and not trying can cause permanent complications such as muscle and joint stiffness, muscle spasms, and blood clots.

With time the condition of the patient is likely to get better rather than worsening. There are many therapies and treatment options to help hemiparesis patients recover from their partial body weakness and aid them live an independent and quality life.

Additionally, many of the functions of the damaged brain cells are compensated by the undamaged brain cells and also the strengthened body muscles can assist the weaker muscles in balancing, walking, grip, and in performing other bodily functions.

• Eat high-calorie and nutrient rich foods to gain energy for your physical therapies and recovery.
• Getting plenty of rest is very important for your overall health.
• Keep yourself hydrated.
• Staying active can help with mobility and aid in any stiffness.
• Undergo physiotherapy and other needed therapies to help you live a quality life.
• Stimulate your brain to make the nerve connection stronger.
• Work with a speech specialist in order to work on your speaking and swallowing ability.

• Hemiparesis treatments can leave a patient exhausted and drained due to weak muscles.
• Not being able to perform simplest tasks can leave them frustrated, irritated and emotionally disturbed.
• Sleeping a lot due to medicines.

Injury to the nervous system might result in hemiparesis as a consequence to the damaged and dead brain cells. Neuroplasticity, fortunately, enables the central nervous system to heal and repair itself by building, rearranging, and strengthening new neural pathways.

Hemiparesis sufferers can improve movement on their weakest side through physical exercise and other therapeutic therapies. Because neuroplasticity needs repetition and consistency to happen, it is crucial to be diligent with home therapy.