Hemiplegia itself is a symptom, not a disease, and the differential diagnosis focuses on the different causes and sites of hemiplegia symptoms. Common injury sites include the cortex and subcortex, the internal capsule, the brainstem, and the spinal cord.
1. Cortical and subcortical injuries: common causes include cerebrovascular disease, craniocerebral trauma, tumors, etc. Generally, paralysis of the upper limbs is obvious, and when there is a lesion in the parietal lobe of the brain, there can be cortical sensory deficits, which are manifested as normal tactile sensation, and deficits in solid sensation and positional sensation. When there is right cortical hemiplegia, it can be accompanied by aphasia, dysarthria and other symptoms, and when there is bilateral subcortical hemiplegia, there can be consciousness disorder.
2. Internal capsule injury: paralysis of upper and lower limbs, including facial and tongue muscles, occurs on the opposite side of the lesion, while the muscles innervated by the cortex may be normal bilaterally. The common cause of the disease is the lesion of cerebral bean artery, rupture and bleeding or stenosis and occlusion.
3. Brain stem injury: generally manifested as crossed hemiplegia, one side of the cerebral nerve paralysis, accompanied by paralysis of upper and lower limbs on the opposite side, which is mainly caused by lesions of the brain stem.
4. Spinal cord injury: when the spinal cord is half or partially diseased, paralysis of the upper and lower limbs on the same side of the spinal cord can be seen.
There are many diseases that can cause hemiplegia, so it is recommended to consult a doctor in time and standardize the treatment.