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What Is Spastic Hemiplegia?

Spastic hemiplegia is a type of cerebral palsy that causes muscle tightness and involuntary contractions in the limbs and extremities on one side of the body. There is no cure, but it can be managed with surgery, physical therapy, assistive devices, and medication. Damage to the part of the brain controlling movement causes spastic hemiplegia. Oxygen deprivation at birth is a leading cause, and this often results from medical malpractice.

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Spastic hemiplegia is a descriptive name for the type of cerebral palsy that involves spasticity and hemiplegia. Spasticity refers to tightness and muscle contractions, while “hemi” in hemiplegia refers to its impact on just one side, or half, of the body.

Children with this condition experience tight muscles that make desired movements difficult, awkward, or impossible. Spastic hemiplegia can reduce a child’s quality of life and prevent independence during adulthood. Children with this condition require lifelong therapy.

Parenting a child with spastic hemiplegia requires significant resources. Parents can also experience a reduced quality of life as a result of the physical, financial, and emotional demands of rearing a child with spastic hemiplegia. Many parents have sacrificed careers and social connections as a result.

A spastic hemiplegia diagnosis may be the result of a birth injury your child experienced before, during, or shortly after birth. This may be true even if your child was diagnosed years after birth. Our experienced Chicago birth injury lawyers can investigate your child’s case and determine whether medical malpractice is responsible. Contact us today for a free case evaluation.

Prevalence of Spastic Hemiplegia in Children

Cerebral palsy affects approximately one in 345 children in the United States, according to the Centers for Disease Control & Prevention. Approximately 25 percent of children with cerebral palsy have spastic hemiplegia, which is one of three types of spastic cerebral palsy. The other types are as follows:

Spastic hemiplegia is more common than spastic quadriplegia and less common than spastic diplegia. Children with spastic hemiplegia are the least likely of the three types to have intellectual disabilities. They are more likely to have epilepsy than children with spastic diplegia but less likely than children with spastic quadriplegia.

Signs and Symptoms of Spastic Hemiplegia

The following symptoms are early warning signs of spastic hemiplegia:

  • Muscle stiffness and weakness on one side of the body
  • Strong preference for one hand during infancy
  • Using only one hand while playing
  • Holding one hand in a fist but not the other
  • Trouble with balance
  • Difficulty walking
  • Poor development of fine motor skills
  • Failure to reach developmental milestones

While it is normal for children to occasionally reach a developmental milestone later than average, missing several or all of them is a cause for concern. The table below lists important milestones to watch for.

Milestone Age
Head control 2 Months
Rolling over 4 months
Sitting up unassisted 6 months
Walking 1 year

You may notice your child’s arm is affected more than the leg. This is common.

What Causes Spastic Hemiplegic Cerebral Palsy?

Spastic hemiplegia results from brain damage to the part of the brain controlling movement. The damage typically occurs on the opposite side of the brain as the affected side. For example, if your child’s left side is affected, the brain damage is on the right side.

Although cerebral palsy is commonly associated with premature birth, spastic hemiplegia is more likely to occur in full-term infants and often results from a perinatal stroke.

Whether your child suffered a stroke, abnormal brain development during pregnancy, or any other insult to the brain before, during, or shortly after birth, your child’s spastic hemiplegia could be rooted in medical malpractice. Call us today at (877) 374-1417 if any of the following occurred during pregnancy or birth:

Complications of Spastic Hemiplegia

Children with spastic hemiplegia tend to strongly favor the unaffected side, potentially leading to abnormal growth patterns in the affected side from lack of use. Bones grow in response to pressure. Lack of use can cause the bones in the affected arm and leg to grow less than the affected side, resulting in smaller and thinner bones.

Unequal use of both sides of the body may also affect the curvature of the spine and lead to scoliosis.

Children with spastic hemiplegia may walk on their toes on the affected side as a result of tight heel tendons. You may notice an abnormal gait and a tendency to lean toward one side due to an inability to control the muscles in the trunk. Your child will likely lack fine motor skills in the affected hand.

Children with spastic hemiplegia may also develop developmental disregard, a condition where the child learns to avoid using the affected arm altogether. The brain becomes trained to automatically prefer the unaffected arm, even when the affected arm is capable.

Over time, the child can lose the necessary coordination to use both hands simultaneously, making it difficult to perform daily tasks. Eventually, the affected arm loses the musculature and structure needed to perform any tasks.

At What Age Are Children Diagnosed With Spastic Hemiplegia?

Children may be diagnosed with spastic hemiplegia between the ages of 12 and 18 months, but this can vary based on the severity of the condition. One of the telltale signs of the condition is a hand preference before 18 months.

The signs of spastic hemiplegia may be more subtle at younger ages, especially in mild cases. By the time a child reaches 18 months old, the warning signs may become more apparent. You should talk to your child’s doctor if you notice any of the following symptoms in your 18-month-old:

  • Has not started walking or requires a lot of support
  • Occasionally walks on the toes, especially on one side
  • Movement or posture seems abnormally asymmetrical
  • Has a well-established hand preference

Treatment and Prognosis for Spastic Hemiplegia

There is no known cure for spastic hemiplegia, but there are many treatment options that can greatly reduce symptoms and improve fine motor skills. Treatment prognosis will depend on many factors, especially the severity of the condition.

The following approaches can help your child increase strength and coordination to promote independence and improve the quality of life:

  • Physical therapy – This involves targeted exercises to stretch tight muscles and increase strength, flexibility, and movement patterns.
  • Occupational therapy – Such therapy includes training to use adaptive equipment and techniques for performing daily tasks, including practice with activities that require fine motor skills.
  • Orthotics – Devices such as braces and casts can support the trunk and stabilize the limbs to keep them in place and provide gentle stretching over time.
  • Surgery – Typically a last resort, surgery may be performed to realign or lengthen muscles. In severe cases, nerve roots may be cut to reduce discomfort. This procedure is known as selective dorsal rhizotomy.


Neuroplasticity is the brain’s ability to rewire itself in response to activity. This ability is strongest in infants and toddlers. Children with spastic hemiplegia can take advantage of neuroplasticity by performing specific, repetitive movements on the affected side.

As the brain detects an increased demand for the task, it will begin forming new neural pathways in undamaged areas of the brain to facilitate the task. This can lead to permanent improvements in spasticity.

One way this is accomplished is through constraint-induced movement therapy, typically involving the arm. The therapist may encourage your child to wear a glove on the unaffected hand to encourage using the affected hand between therapy sessions.


An additional non-operative treatment option includes symptom management through medication. Common oral medications often effective in children who only require mild reductions in muscle tone include the following:

  • Diazepam
  • Baclofen
  • Dantrolene sodium
  • Tizanidine

Baclofen may also be delivered directly into the fluid surrounding the spinal cord through an implantable pump. The medication decreases the excitability of nerves near the spinal cord, reducing spasticity throughout the body. The dosing can be customized based on when spasticity tends to be the worst.

Botulinum toxin, or BT-A, may be injected into the muscles to provide relief from overactive nerve cells activating muscles. The effects of BT-A can last three months. This approach is generally most effective when combined with physical therapy.

Resources for Parents and Caregivers of Children with Spastic Hemiplegia Cerebral Palsy

Caring for a child with spastic hemiplegia cerebral palsy comes with a host of unique challenges. Many resources exist to provide support and help ensure your child’s physical, emotional, and educational needs are met.

The Individuals with Disabilities Education Act, or IDEA, is a federal initiative offering various resources to help children with disabilities, including cerebral palsy. After evaluation and assessment, you’ll receive assistance with creating an Individualized Family Service Plan.

IDEA emphasizes early intervention services, and your child’s plan may involve aid with:

  • Assistive technology
  • Hearing, speech, and language services
  • Medical, nursing, and nutrition services
  • Occupational and physical therapy services
  • Psychological services
  • Family counseling and training

The goal of the initiative is to make services accessible and affordable for all people dealing with a type of cerebral palsy or other serious condition. Some services are offered free of charge, while others are priced on a sliding-scale basis.

The following suggestions can help caregivers find assistance and support after a child is diagnosed with spastic cerebral palsy:

  • Stay up-to-date on new healing modalities
  • Learn about new assistive technologies
  • Educate yourself on cerebral palsy
  • Connect with other CP caregivers

Organizations like The Cerebral Palsy Family Network, United Cerebral Palsy, and The Cerebral Palsy Support Network offer a robust network for families and a wealth of resources for further education and support.

$6.5 Million


settlement for a young girl who suffered a brain injury during birth, resulting in cerebral palsy, after physicians failed to timely perform a c-section.

$4.5 Million


for a child who suffered brain damage causing cerebral palsy as a result of a family practice physician’s failure to perform a timely Caesarean section in the face of fetal distress.

$2.35 Million


for a child who suffered severe brain injury and cerebral palsy as the result of a uterine rupture in a vaginal birth after Caesarean (VBAC) delivery that could have been avoided.

Legal FAQs in Spastic Hemiplegia Claims

If your child has been diagnosed with spastic hemiplegia, you may have legal options to obtain compensation. Below are answers to questions you may have about filing a spastic hemiplegia lawsuit.

Determining liability requires evidence that one or more health care providers violated their duty of care and caused or contributed to the diagnosis. Those responsible may include the following:

  • Doctors
  • Nurses
  • Midwives
  • Physician assistants
  • Anesthesiologists
  • Pathologists
  • Pharmacists
  • Hospitals
  • Birthing centers

Every state sets a time limit on birth injury claims known as the statute of limitations. The deadline varies widely between states, and many states allow the child to file a lawsuit well after the parents’ statute of limitations has expired. The Illinois medical malpractice statute of limitations is generally two years after your child is diagnosed. Your child may be entitled to file a claim for up to eight years.
Our attorneys can answer any questions you may have about the cerebral palsy statute of limitations or other deadlines, requirements, and restrictions and advise you whether your case is still timely.

You may be eligible to recover damages for your lost wages, your child’s medical expenses related to spastic hemiplegia, transportation costs, and any other financial losses associated with your child’s diagnosis. You may also be eligible for damages related to the pain and suffering the diagnosis has caused your family.

Your child may be able to file a separate claim for their own losses, including the lifetime cost of medical care, pain and suffering, lost earning capacity, and expenses for non-medical services.

How Can Levin & Perconti Help Me if My Child Has Spastic Hemiplegia Due to a Birth Injury?

With more than 400 years of combined experience helping children and families affected by birth injuries, we understand how devastating a spastic hemiplegia diagnosis can be. We are dedicated to helping children and families get justice against negligent health care providers.

We were one of the first law firms to take on large health care organizations on behalf of children injured at birth through medical carelessness. As pioneers in birth injury litigation, we have recovered more than $2 billion in case results for our clients. Our attorneys have received national recognition as top advocates of birth-injured children.

  • Partner Dov Apfel is a nationally renowned advocate of children with cerebral palsy and developmental disabilities. He is a highly sought-after author, lecturer, and leader who has helped shape birth injury litigation today.
  • Partner Seth Cardeli recently taught lawyers how to interpret fetal heart tracings and holds numerous leadership positions with the American Association for Justice.

Mr. Cardeli and Mr. Apfel have each won multiple multi-million verdicts for children with cerebral palsy and their families.

We have developed the most effective and aggressive approach in birth injury cases, and our knowledge of state and federal medical malpractice laws is unmatched. We will not settle for less than you deserve. If your child has been diagnosed with spastic hemiplegia, contact us today to schedule a free consultation.