
A stroke can cause weakness in the leg, and this is a common symptom. The impact of a stroke can be mild or severe, and it can affect any part of the body. In some cases, only one leg is affected, and the weakness comes on suddenly. Hemiparesis, or one-sided muscle weakness, is a key symptom of neurological problems and can be a sign of a stroke. It happens because of disruptions in the brain, spinal cord, or nerves that connect to the muscles. About 80% of stroke survivors experience hemiparesis.
Characteristics | Values |
---|---|
What | A slight stroke |
Why | Blockage or bursting of a blood vessel in the brain |
Where | Brain, spinal cord, or nerves |
How | Interruption of blood flow to the brain or sudden bleeding in the brain |
Symptoms | Weakness in the leg, hand, and arms; drooping of one side of the face; difficulty speaking; loss of balance; bladder and bowel problems |
Treatment | Physical therapy; electrical stimulation therapy; cortical stimulation therapy; mental imaginary therapy; assistive devices |
What You'll Learn
- Hemiparesis: one-sided muscle weakness, a key symptom of neurological issues
- Foot drop: difficulty lifting the foot and toes
- Dysphagia: swallowing problems
- Spasticity and contractures: muscle stiffness
- Cerebral lesions: lesions in the anterior cerebral artery, middle cerebral artery, internal capsule, brainstem regions, or thalamus
Hemiparesis: one-sided muscle weakness, a key symptom of neurological issues
Hemiparesis is a condition characterised by one-sided muscle weakness, which can affect the face, arm, and leg, or a combination of these body parts. It is a symptom of disruptions in the brain, spinal cord, or nerves connecting to the affected muscles. Hemiparesis is a key indicator of neurological issues, and while it can occur due to non-threatening conditions, it can also be a sign of life-threatening medical emergencies, such as a stroke.
Causes of Hemiparesis
Hemiparesis can be caused by a variety of factors, including:
- Strokes or transient ischemic attacks (TIAs), particularly lacunar strokes, resulting from blockages in small blood vessels in the brain.
- Aneurysms and haemorrhages inside the brain.
- Concussions and traumatic brain injuries (TBIs).
- Spinal cord injuries.
- Birth injuries or conditions like cerebral palsy.
- Facial paralysis conditions, such as Bell's palsy.
- Seizures and epilepsy.
- Bleeding between the brain and its outer layers or between the skull and the brain's outer membrane.
- Brain tumours, including cancers.
- Nervous system diseases, especially autoimmune and inflammatory conditions, such as multiple sclerosis (MS) or progressive multifocal leukoencephalopathy (PML).
- Infections affecting the nervous system, including encephalitis, meningitis, or Ramsay Hunt syndrome.
- Certain migraine headaches, known as hemiplegic migraines, which are related to the symptom of hemiplegia.
Symptoms of Hemiparesis
In addition to muscle weakness on one side of the body, other symptoms of hemiparesis include:
- Inability to maintain balance.
- Difficulty grasping objects.
- Reduced precision in movement and lack of coordination.
- Leaning to one side while standing, walking, or sitting.
- Loss of bowel or bladder control.
Treatment and Recovery
The treatment of hemiparesis focuses on addressing the underlying cause. In the case of a stroke, which is the most common cause, treatment aims to restore blood flow to the affected area of the brain. Long-term treatment of hemiparesis aims to improve motor skills, coordination, and the ability to perform everyday activities. Physical and occupational therapy play a crucial role in the recovery process, helping individuals regain movement and improve strength and mobility over time.
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Foot drop: difficulty lifting the foot and toes
A stroke can cause weakness in the leg, hand, and arms. This weakness can manifest as foot drop, which is a symptom where you drag your toes when walking due to weakness or paralysis of certain muscles in your foot. Foot drop can affect one or both feet and can cause you to drag your toes when walking. It can also cause you to lift your knee higher than usual to avoid dragging your toes on the ground. This can increase the risk of tripping and falling.
Foot drop is usually caused by an injury to the peroneal nerve, which runs down your leg and controls the muscles that lift your foot. This can be caused by a slipped disc in the spine, crossing your legs, kneeling or squatting for long periods of time, peripheral neuropathy caused by diabetes, hip or knee replacement surgery, or staying in the same position for a long time, such as during a hospital stay.
Foot drop can also be caused by damage to the brain or spinal cord, which can be the result of a stroke, cerebral palsy, Parkinson's disease, or multiple sclerosis. If you are experiencing foot drop or any other form of leg weakness, it is important to seek medical attention as soon as possible, as it may be a sign of a serious underlying health issue.
Treatment for foot drop depends on the underlying cause and can include physical therapy, braces, splints, or shoe inserts, or surgery. In some cases, foot drop may go away on its own or with treatment, but in other cases, it may be permanent.
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Dysphagia: swallowing problems
A stroke can cause a swallowing disorder called dysphagia. This occurs when the parts of the brain that coordinate the many different muscles involved in swallowing are damaged. Dysphagia can lead to poor nutrition, pneumonia, and disability if not identified and managed.
A common problem for people with dysphagia is aspiration, which is when swallowed food enters the airway and lungs. Normally, this causes a violent cough, but a stroke can reduce sensation, and the person affected may not realise they are aspirating (silent aspiration).
Signs of dysphagia include:
- Coughing or choking when eating or drinking
- Regurgitating food, sometimes through the nose
- Food or drink going down the wrong way
- Feeling that food is stuck in the throat
- Inability to keep food or drink in the mouth
- Food or drink left in the mouth after swallowing
- Difficulty chewing food properly
- A croaky or 'wet' sounding voice
- Saliva escaping from the mouth
- Taking a long time to swallow or finish a meal
- Needing to swallow a lot or loudly clear the throat
- Shortness of breath when swallowing
If you are experiencing dysphagia, you should be referred to a speech and language therapist, who will complete an assessment and advise on the best ways to treat or manage your swallowing difficulties. They may recommend learning techniques to help you swallow, using aids to help you eat or drink more easily, or practising exercises to strengthen the muscles in your throat, face, and mouth.
It is important to make changes to your diet if you are experiencing dysphagia. A speech and language therapist can advise on the right consistency of food and liquid for you to swallow. They may recommend modifying the texture of food (e.g. softening, chopping, or pureeing) and adjusting the thickness of liquids. They may also suggest drinking chilled or flavoured thickened drinks and eating soft or pureed food.
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Spasticity and contractures: muscle stiffness
A stroke can cause weakness in the leg, hand, and arms. This is due to the impact of the stroke on the brain, which can cause damage to the way nerves control the muscles. This is known as spasticity or hypertonia, and it can develop within a week of a stroke or some time later. Spasticity affects around one in four stroke survivors and can cause significant difficulty with daily living tasks.
Spasticity is characterised by stiff or rigid muscles, which can make it difficult to move your arms or hands, or tight leg muscles can affect your walking. The elbow, wrist, and ankle are commonly affected, and the surrounding tendons and soft tissue can become tight, making it difficult to stretch the muscle. If left untreated, spasticity can lead to contractures, which are permanent shortenings of the muscles, causing the joint to become stuck or frozen in an abnormal and possibly painful position.
There are several ways to treat spasticity and contractures, including physical therapy, oral medications, and injections of botulinum toxin. Injections of botulinum toxin work by blocking the action of the nerves on the muscle, reducing its ability to contract. Oral medications can also help relax the nerves so that they don't send a continuous message to the muscles to contract.
If you experience any warning signs of a stroke, such as sudden leg weakness, it is important to seek emergency medical care.
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Cerebral lesions: lesions in the anterior cerebral artery, middle cerebral artery, internal capsule, brainstem regions, or thalamus
A stroke is a type of brain lesion that can cause weakness in the right leg. Brain lesions refer to areas of damaged brain tissue that disrupt the way your brain works, causing a wide range of symptoms. The brain's arterial supply comes from the internal carotid arteries and the vertebral arteries, which meet at the base of the brain to form the circle of Willis. The internal carotid artery then divides into the anterior cerebral artery, the middle cerebral artery, and the posterior cerebral artery.
Anterior Cerebral Artery Lesions
The anterior cerebral artery (ACA) supplies oxygenated blood to most midline portions of the frontal lobes and superior medial parietal lobes. It also supplies the frontal, pre-frontal, and supplementary motor cortex, as well as parts of the primary motor and primary sensory cortex. ACA infarcts are rare due to the collateral circulation provided by the anterior communicating artery. However, ACA infarct can present as contralateral hemiparesis with loss of sensibility in the foot and lower extremity, and sometimes with urinary incontinence.
Middle Cerebral Artery Lesions
The middle cerebral artery supplies most of the lateral aspects of the cerebral hemispheres, as well as portions of the caudate nucleus and the putamen. Lesions in the middle cerebral artery can cause a pure motor stroke, resulting in weakness of the face, arm, and/or leg.
Internal Capsule Lesions
The internal capsule is a unique location where a large number of motor and sensory fibres travel to and from the cortex. Lesions in this area can cause relatively unique findings, such as weakness of the face, arm, and/or leg (pure motor stroke). A stroke in the posterior limb of the internal capsule can lead to contralateral weakness and contralateral sensory loss.
Brainstem Lesions
The brainstem is a stalk-like structure that connects the brain to the spinal cord. Lesions on the brainstem can disrupt vital functions such as heart rhythm, breathing, blood pressure, and eye alignment.
Thalamus Lesions
The thalamus is an egg-shaped structure in the middle of the brain that acts as a relay station for all incoming motor and sensory information. It plays a role in sleep, wakefulness, consciousness, learning, and memory. Lesions in the thalamus can cause symptoms such as memory loss, lack of interest or enthusiasm, loss of the ability to understand language or speak, trouble with attention, and trouble processing sensory information.
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