Clinical features and outcomes of hemiplegic cerebral palsy

  Most children with hemiplegic cerebral palsy present with spastic hemiplegia. Spastic hemiplegia often occurs in full-term infants born at normal weight, and most cases are caused by developmental disorders, prenatal circulatory disorders, neonatal stroke and infant cranial trauma. The symptoms of hemiplegia are similar to those of adult stroke patients, with the upper limbs often showing flexion of the elbows and wrists, and the lower limbs often showing pointed feet, internal rotation of the thighs, and flexion and spasticity of the hip joints in the standing position. In sitting position, due to the instability of the center of gravity, the patient often shows a posture pattern of internal rotation and inward tendency of the lower limbs. When walking, the lower limbs often move forward on the healthy side, and the face is slightly skewed to the healthy side. Patients with hemiplegia walk up stairs on the healthy side first, followed by the affected side. When descending stairs, the affected side goes first, followed by the healthy side. This is the only way to maintain balance and not to fall. Generally speaking, these children have a good prognosis and can walk independently at about 18 months of age, but they often have hand function disorders.