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What's treatment for a spastic hemiplegia due to a tuberculous meningitis ?
17 مارس 2015

د. Zakia Dimassi طب الأطفال

Hemiplegia, usually
a sequel of a brain injury, manifests as a number of physical, cognitive, and
behavioral effects:



§  Memory – Difficulty with encoding, storing, and retrieving
new information.



§  Attention and Concentration – Trouble with focusing and sustaining attention for long
periods of time, especially in situations where there is too much stimulation
from the surrounding environment, such as a great deal of noise. Switching from
one topic or activity to another also imposes difficulty.



§  Executive Functions – Difficulty setting appropriate goals, planning and
organizing behavior to accomplish tasks, and monitoring and evaluating
behavior.



§  Speech and Language – such as lack of speech or extremely slow speech. These
may improve with time, depending on the gravity of the injury.



§  Social Communication – Difficulty in interpretation of social cues,
organization of ideas, and application of rules of social behavior.



§  Behavior – The affected individual may be prone to agitation,
irritability, hyperactivity, apathy and emotional and behavioral outbursts.



§  Sensory Effects – Problems with vision and impaired coordination of both
eyes. The brain’s visual processing area may be injured, thus affecting the
ability to see in all visual field (partial losses of vision). Hearing may also
be affected.



§  Seizures – Usually can be controlled through medication.



Hemiplegia is not a
progressive condition, but problems with muscle spasticity and atrophy (thinning,
mainly because of disuse) can occur. Weight bearing and strengthening exercise
may help prevent atrophy and increase use.



The affected
individual is also at a higher risk of developing scoliosis; this matter must
be followed by a specialist.



Hemiplegia is not a
curable condition, but with continuous therapies can help with some of the
symptoms. 
Physical therapy is the standard
treatment for spastic hemiplegia. This therapy encompasses various methods, the
primary aim of which is to strengthen the muscles and prevent further muscle
stiffening. Additionally, medications to relax spastic muscles are used to help
with the muscle spasticity. If seizures occur, they can be controlled with
medication. Surgical interventions may be needed in cases of limb deformities,
but prevention is key to avoid this complication (by proper positioning and
physiotherapy). Braces and other orthopedic devices can support movement and
help prevent deformed limbs.



 

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