Cerebral Palsy and Left Side Motor Impairments: Managing Spastic Hemiplegia

Cerebral palsy is a developmental condition that affects motor functions. Sometimes movement on both sides of the body is affected; other times, the right or left side can be affected. This article will focus specifically on left side cerebral palsy.

When cerebral palsy only affects the left side of the body, individuals may experience difficulties with balance, coordination, and posture. By learning how to manage motor impairments on their affected side, individuals can learn to use both sides of their body equally to efficiently perform everyday activities.

To help you better understand cerebral palsy that affects the left side, this article will discuss causes, potential secondary effects, and effective management interventions. 

Understanding Cerebral Palsy That Affects the Left Side

When cerebral palsy affects only one side of the body, it is called spastic hemiplegia. To understand this condition, it helps to have a basic understanding of how the brain controls movement.

The brain consists of 2 hemispheres. The right hemisphere controls movement on the left side of the body and the left hemisphere controls movement on the right. Therefore, motor impairments on the left side of the body are caused by damage to the right side of the brain, specifically the motor cortex.

While spastic hemiplegia is one of the most common types of cerebral palsy, individuals may experience a wide variety of secondary effects at varying severities. As a result, even amongst individuals with spastic hemiplegia, everyone experiences cerebral palsy differently.

One common characteristic among individuals with this type of cerebral palsy is that they often present with more severe motor impairments in the arm and hand of the affected side than in the leg. In the following section, we’ll discuss other common effects of spastic hemiplegia and possible consequences of left side motor impairments.

Effects of Hemiplegic Cerebral Palsy

Because cerebral palsy generally affects the body very early in life, it can interfere with a child’s growth and development.

Spastic cerebral palsy is primarily characterized by high muscle tone (spasticity). When only one side of the body experiences spasticity, it can harm a child’s growth due to excess strain on the joints and muscles. In comparison to the nonaffected side, the affected side may not be able to grow or function optimally.

Spasticity can restrict range of motion and discourage children from using their affected side. As a result, children may become overly dependent on their non-affected side and may not develop bilateral coordination skills.

For example, if a toy is on the child’s left side, they may turn their entire body to grab the toy with their right hand rather than pick it up with their left hand. Ultimately, failing to develop bilateral coordination skills can make it difficult for individuals to perform daily self-care activities such as dressing and grooming.

Other common effects of left side motor impairments related to cerebral palsy include:

• Stiff movements
• Abnormal gait (walking pattern)
• Asymmetric growth
• Distortions
• Unstable trunk control (leaning to one side)
• Poor fine motor skills in the affected hand

Because every individual experiences spastic hemiplegia differently, it’s essential to seek personalized care. In the following section, we’ll discuss management interventions for left side motor impairments.

Management of Spastic Hemiplegia

To prevent complete neglect of their affected side (developmental disregard), individuals with spastic hemiplegia must learn to manage their spasticity and practice using both sides of their body.

Below, we’ll discuss 5 management interventions that can help individuals manage their left side motor impairments.

Physical Therapy

The goal of physical therapy is to help improve a client’s motor control through targeted exercises. Physical therapy for left side motor can involve stretching tight muscles, strengthening underused muscles, and practicing new movement patterns.

Ultimately, individuals work on promoting neuroplasticity (the brain’s ability to rewire itself) by repetitively practicing exercises using their left side. Repetitive stimulation signals to the brain that there’s a demand for movements using the left side of the body.

With enough practice, the brain may be able to reorganize functions affected by cerebral palsy to healthy, undamaged areas of the brain.

Occupational Therapy

Occupational therapy can help individuals with motor impairments on their left side become more independent by practicing activities of daily living like using silverware, writing, and brushing your teeth. Additionally, individuals may practice using both sides of their body to develop bilateral coordination skills and perform tasks more efficiently.  

An occupational therapist also assesses whether clients can benefit from using adaptive tools like walking aids or orthotic devices like ankle-foot orthoses.

Medications

Medications like baclofen and Botox can help temporarily reduce spasticity by inhibiting signals that cause muscles to contract.

Botox is injected directly into spastic muscles. In contrast, baclofen can be taken orally or injected through an intrathecal pump. However, because pills and intrathecal pumps administer the muscle relaxant throughout both sides of the body, they’re generally not ideal for individuals with motor impairments on only one side of the body.

Another significant difference between these two medications is how long their effects last. Baclofen must be taken regularly because its effects generally last for several hours. In contrast, the effects of Botox typically last anywhere between 3-6 months.

Regardless, medications won’t permanently reduce spasticity. Instead, individuals should take advantage of their reduced muscle tone and practice moving their affected side as much as possible to promote adaptive changes in the brain.

Orthotics

Orthotics support correct musculoskeletal alignment. Because cerebral palsy occurs in early childhood, spastic hemiplegia can significantly affect the way a child’s body develops.

Spasticity on one side of the body can restrict normal growth and compromise posture due to uneven muscle strain.

Wearing orthotics can help provide trunk support, hold the limbs in place, and provide prolonged gentle stretching of spastic muscles.

Surgery

Because of its invasive and costly nature, surgery is generally recommended as a last resort.

Surgery for spastic hemiplegia generally involves manually lengthening and realigning the muscles or selectively cutting the nerve roots for a specific muscle to reduce its excitability.

Cerebral Palsy and Left Side Motor Impairments: Key Points

Left side motor impairments in individuals with cerebral palsy are the result of damage to the right motor cortex.

Because movements on the right side of the body are unaffected, children may become overly dependent on their right side and avoid using their left side. It’s essential for individuals to practice using both sides of their bodies in order to develop bilateral coordination skills.

By consistently practicing movements with their affected side and managing their spasticity, individuals with spastic hemiplegia can stimulate neural adaptations in the brain and improve motor control on their affected side.

Photos from top to bottom: iStock/KatarzynaBialasiewicz/wavebreakmedia