Right Hemiplegia - Any Suggestions?
David J West
david/web.net.au at web.net.au
Tue Apr 2 22:19:08 EST 1996
I would be very interested in learning anything more about my hemiplegia -
particularly any suggestions from the medical profession. Alternatively, I
would like to hear from people who are in a similar position to myself.
In September, 1984 and at the age of 17, I had a car accident in which I
suffered a right hemiplegia. All details of my resultant disabilities and an
account since the accident are listed below.
I have limited functional movement of my right shoulder, arm and elbow,
since they are quite spastic. My hand has the ability to grasp, while my arm
has some distinct uses that involve acting on resistive forces. Examples
being, lifting weights, chin-ups, push-ups, holding and carrying bulky
objects, etc. For anything involving fine coordinated movements, they are of
little functional use. My leg has also been partially affected. While these
exercises do maintain my right side's mobility, I do not feel they are
helping in the long term.
It is also interesting to note that my right side totally relaxes whilst
A report written upon discharge from hospital diagnosed that I had received
a deep intra-cerebral haematoma. Quoting the report: 'C.T. Scans showed an
area of haemorrhage in the left thalamus surrounded by oedema. There were
separate areas of punctate haemorrhage, more superiorly placed within the
same hemisphere and the ventricular system was quite small. Repeat CAT scans
showed the haematoma to be resolving and there was a moderately large
infarct on the left internal capsule with encroachment upon the left
thalamus at the site of the previously described haematoma.'
A report written by a rehabilitation doctor 6 months after the accident
said: The residua from this accident are in the form of bilateral upper
motor neurone lesions affecting all four limbs, with increased tone,
positive Hoffmann and extensor Babinski signs. The right side is by far the
worst and this is his dominant side"
In April, 1985, as an inpatient of the Royal Perth Rehabilitation Hospital,
I was expected to swim in the hydrotherapy pool. I had lost all of my
confidence in water (this being a side-effect of the accident) and I was
literally terrified of the thought of my head being submerged in water. When
the time came to swim, panic set in and both my arms and hands started the
motions of "dog-paddle".
This function of my right arm was caused by - according to my instincts - a
life-threatening situation and only lasted until I realised that I wasn't
going to drown. I couldn't understand why I wasn't able to swim or even put
my head underwater (without breathing in) especially when being confident in
water was of second nature before the accident. Many months were spent
trying regain my confidence in water and now, I would only panic if I was
actually drowning. To this day, I still cannot confidently put my head
Also, on the rarest of occasions, from impulse and for an instant, my right
hand and arm have displayed reflex-action type movements. eg. stopping a
glass jar from falling off a shelf, jumping when startled by anything, and
my whole arm has withdrawn my hand from painful situations. I would have
doubts, though, about these rare instances leading to anything, if not for
the day in the hydrotherapy pool.
Regrettably, there were no residual effects resulting from these
experiences. It just seems very irregular that my arm and hand have the
potential to function normally but can only do so in extreme circumstances.
It has been 12 years since the accident and during this time, I have seen
several specialists. A physiotherapist found that by constant and vigorous
shaking of the fingers and hand made them relax. My physiotherapist has also
tried interferential treatment on the right forearm. This didn't have the
desired effect and for the time that it was being tried, increased my hand
and finger's spasticity. Soon after the accident my physiotherapist in
hospital tried limited biofeedback but this too was also unrewarding.
Prior to being discharged from hospital in 1985, I had a condition known as
"drop-foot" and tenotomies were performed on both Achilles tendons Plus, my
right forearm was flexed against my throat so a tendon release was also
performed. In the years after being discharged, I had several minor
orthopaedic operations to improve my function. Not being critical to this
kind of treatment but it has inherent limitations in that it can only do so
Neurologists and Doctors have tried many drugs including: Sinemet-M, Valium,
Baclofen, Rivitrol, Tegretol, Artane and Epilim. The Doctors involved with
prescribing Sinemet-M explained that this drug is usually used on people who
suffer from Parkinson's disease.
With people who suffer from this disorder, the brain sometimes lacks the
drug. Two symptoms of this deficiency are the relaxation of the spastic
limb(s) whilst asleep and the spastic limb(s) being able to move more
readily against resistance. In my case, these symptoms were true and since
the nature of my head-injury was uncertain, it was possible that Sinemet-M
At any rate, Epilim was the only agent that seemed to help and I am now
taking a daily dosage of 3 x 500mg. Although Epilim hasn't affected my hand
and arm's usefulness, it has however, lessened the spasticity of my right
side thus making it more comfortable for me. My Neurologist said that
relaxation of my (R) side was the maximum benefit of trying all the drugs
and agents because the brain was affected in the accident.
In the past, I have also seen a hypnotherapist. It was my theory that if I
could be induced into a panic situation - under hypnosis - then, I could not
see any problem in getting my hand and arm to "work". If my hand and arm had
performed differently under certain circumstances, then prolonging the
effects into everyday situations might be possible. I asked a rehabilitation
doctor about hypnotherapy. He said: 'He would have to be a good hypnotist!'.
Realistically, I could see his point.
About a year later I asked my GP if I could be referred to a hypnotherapist.
He had no hesitation in obliging me because he said that he was going to
refer me anyway. I was relieved - he actually took me seriously.
Among other things, the hypnotherapist tried regression - taking me back
with hypnosis to the hydrotherapy pool. This didn't work although he only
tried because I wanted him to. In summary, I was not surprised at the
failure of hypnotherapy but was somewhat annoyed with the hypnotherapist's
pessimistic attitude. It was like all things: if I didn't try, I would never
I initially thought it was the panic involved with my head going underwater
that made my hand and arm function. However, in September, 1988, to try and
arouse the panic situation, I went skydiving - Deluxe Tandem.
We tried free-falling from 10,000ft at 120mph, for 45 seconds by firstly
doing two forward rolls. This didn't work and not too disappointingly
either. To be quite honest, I was doing it just for the thrill with an
ulterior motive in mind; I'll be the first to admit that my methods were a
little excessive but by all accounts, it was feasible. All the exercise did
accomplish was to make me feel decidedly ill and quite arguably, it was the
wrong way to approach the problem.
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