I noticed that one of the posts on my blog that gets the most attention is Hemiparesis vs. Hemiplegia. I also noticed it doesn’t get much love. Finally, I reread it and saw how long it takes to get to the part about one versus the other. So if you want a more personal account click the hyperlink above, otherwise, stay here and I’ll try again to define it.
What is hemiparesis?
If you break down the word it’s pretty simple to understand. Hemi: half; paresis: weakness.
Hemiparesis is typically defined as weakness of one half of the body. It is caused by a number of things but the most common are stroke, cerebral palsy and brain injury. Most people, including myself, simply call it “partial or mild paralysis” and some say “weakness” of one side of the body.
We say weakness or partial paralysis because that’s basically what it is. You can move your arm but your ROM (range of motion) is limited. You may be able to open and close your hand but your grip might not be strong enough to really hold on to anything. Or, maybe you can control your grip just enough to not squeeze too hard or too lightly but the strength in your arm or shoulder might have a low limit to what weight you can safely lift and carry. While your hand can assist in tasks, your fingers may not take part, making fine motor skills limited or now unavailable.
With hemiparesis, there is a good chance of feeling unbalanced because of the inability to properly shift weight to your affected side. You are likely to have feeling on your affected side but it is also just as likely to not have, say, a strong signal and it causes you to feel wobbly and lack that extra confidence needed to walk unassisted. There is a good chance that with hemiparesis daily activities will be a struggle but do not necessarily require assistance.
What is hemiplegia?
Like above, it’s easier to start by breaking down the word. Hemi: half; plegia: paralysis.
Hemiplegia differs from hemiparesis in seemingly minute ways. You might think paralysis is paralysis and weakness is weakness; one can move even if only a bit and the other doesn’t move at all. It’s a bit more complicated than that in this scenario. Maybe it’s not that complex to doctors, which I doubt, but to a patient it is confusing and difficult to understand. As much as people don’t want to be labeled or beneath one blanketing term, we still kind of want to know where we stand on whatever subject we’re discussing. We want to know our odds, what may lie ahead of us, how to better ourselves or how best to handle the unexpected. The only way to do this is to have a group to study, yeah? This group could be like this post, a grouping of terms that make up the conditions of my life that I don’t understand and by involving this group, I can learn more about me through them.
So maybe I’m not hemiparetic, maybe it’s more than just weakness because I can’t open my hand. Hell, I can barely close my hand anymore and that used to be all I could do. When you feel like you are slipping out from under that blanketed term (hemiparetic), you try to figure out what else is best to name your situation and you find hemiplegia. How do they differ and why is so difficult to tell the two apart?
I think what makes it the most difficult is the fact that half of our bodies wind up compensating so much for our affected sides that we slip into this gap between blankets. It’s kind of hard to tell exactly how “paralyzed” you really are. It’s a weird spot to live in. My doctors always said “weakness” and “hemiparesis” when describing me and one day I decided to look it up. It sounded like me but it was depressing because they were talking about releasing and lifting; two things I can’t do is release and lift. I used to have a good grip but I’ve been working on the spasticity in my hand with stretches so my grip, especially in my pinky, has weakened (oddly frustrating).
I found that there is a more severe form of hemiparesis and that’s hemiplegia. Unlike hemiparesis you have very little, if any, voluntary muscle control to one side of your body. Most of your joints like your wrist, elbow and even your fingers try to lock in one place and cause great pain. There’s foot drop which is where your foot just hangs because you have almost no connection to your ankle. You wear a brace for this but you may also wear one with hemiparesis. There’s subluxation of the shoulder which is where the head of your upper arm is partially dislocated from your shoulder. The tendons and muscles surrounding this area become too weak to basically hold everything in place. It’s painful and mine feels…it feels tired.
With hemiplegia, things are more complicated as it often involves other side effects like a loss or misappropriation of sensations to that side of the body or spasticity. I’ve learned in the last 4 years to trust my left leg a bit more so my gait has improved but not the feeling in it. It’s like walking on the bone because I don’t feel anything around the bone, just the hard thud of my heel vibrating to my stiff hip through a stick. Trusting your affected side, whether it’s hemiparetic or plegic is probably one of the most important lessons when learning to live a post-stroke/injury life.
Spastic hemiplegia is one of the most common forms of cerebral palsy and from what I gather from support groups, forums and multiple web sites, it’s [spasticity] also a common symptom of hemiplegia in stroke survivors. Spasticity, simply put, is when your muscles contract and stay that way for long periods of time or duration of an event that is causing some sort of stress. It can make living with any form of paralysis difficult. Spasticity is usually used in reference to hemiplegia but can also be present with hemiparesis.
Why the confusion?
I’m not sure why there is so much confusion among survivors. I’ve seen this topic brought up in a lot of discussion forums and support groups and I’ve seen a lot of misunderstanding among my fellow survivors. I believe it stems from the doctors. So many doctors can’t even diagnose a stroke correctly, how can we expect them to diagnose the residual effects correctly? There’s a miscommunication among the medical community or it’s very possible the line between the two diagnoses is so thin they don’t care for the precision. The internet is also confused. If you Google one, you get results for the other. It’s possible it’s to be decided by the patient though I doubt that since one [hemiplegia] clearly involves a serious lack in controlled function to one side of the body and the other implies limited use of one side of the body due to weakness. Most stroke survivors and cerebral palsy thrivers tend to refer to their affected side as hemiplegic.
Here are some videos to further confuse you!!!