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hemiparesis and hemiplegia

Decline in strength (hemiparesis) or paralysis (hemiplegia) in one half of the body, common in older people. Physical movement is controlled by the cerebral cortex. Nerve fibres run from there to the muscles and cross over before entering the spinal cord, so that the muscles in the left half of the body are served by nerves in the right half of the brain, and vice versa. If the right half of the brain is affected, hemiplegia in the left half of the body occurs as a result. The centres of speech are usually in the left half of the brain, and therefore hemiplegia is accompanied by speech and comprehension disorders only if the right half of the body is paralyzed. The most frequent cause of hemiplegia is a cerebral haemorrhage. Other causes are a brain tumour or severe concussion , but hemiplegia can also occur in such diseases as multiple sclerosis. In conditions which arise suddenly, slack paralysis of the opposite half of the body initially occurs. Speech is frequently indistinct because one corner of the mouth hangs down. The disorder often recurs to a greater or lesser degree, but spasticity often occurs. The course taken by the condition is entirely dependent on the nature and extent of the cause. Reasonable recovery is usually possible, especially after a cerebral haemorrhage. Treatment is directed towards the underlying condition. Therapeutic exercises are also important in order to keep the muscles in optimum condition. The clinical picture may improve in the first two years after the condition commences.

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