Presentation on theme: "Hemiplegia Dr. Shamekh M. El- Shamy. Hemiplegia Definition: paralysis of one side of the body due to pyramidal tract lesion at any point from its origin."— Presentation transcript:
Hemiplegia Dr. Shamekh M. El- Shamy
Hemiplegia Definition: paralysis of one side of the body due to pyramidal tract lesion at any point from its origin in the cerebral cortex down to the 5 th cervical segment.
Symptoms & Signs 1-Acute lesions: the clinical picture passes through 2 stages: A)-Stage of flaccidity: due to neuronal shock. B)-Stage of spasticity: this is the stage of established hemiplegia. 2-Gradual lesions: the hemiplegia passes directly to the stage of spasticity.
– STAGE OF FLACCID PARALYSIS (SHOCK STAGE): -
. STAGE OF SPASTTC. PARALYSIS: 1-Paralysis of one sideof the body.
2-Hypertonia (spasticity) of the paralysed muscles of clasp-knife type : 3-Exaggerated deep reflexes
MANAGEMENT OF HEMIPLEGIA 1-GENERAL:. Care of the skin:. Care of respiration:.Care of nutrition and fluid balance:.Care of the urinary bladder:. Care of the bowels:
Symptomatic Treatment 1.Cerebral dehydrating 2.Antiemetics 3.Tranquilizers and sedatives 4.Muscle relaxents 5.Vitamins and tonics.
3- Physiotherapy 1- Proper positioning of the hemipegic side. 2-Passive,active assited,active exercises.. To minimize contractures. To strength muscles 3-Antispastic methods to control spasticity. 4-Gait and balance training.
4- Specific Treatment 1)- Cerebral Thrombosis: A-Care of Blood Pressure * Hypotensive drugs if B.P is above 200/120. Capotril to50 t.d.s * Vasopressor drugs if B.P is very low. B- Anti platelates: *Aspirin: single dose mg daily *Persantin:75 mg twice daily * Ticlopidine:250 mg twice daily
C- Anticoagulants: used in all cases Indications: Contraindications:
Method : * Heparin * Dindivan or Marcoumar: anticoagulants. - Monitor the dose using the prothrombin time. * Antidote :-
D- Other drugs may be used: 1- Nootropil : 2- Trental : 3- Trivastal : 4- Cerebral Vasodilators :