Acute Hemiplegia in Children: A Prospective Study of Etiology, Clinical Presentation, and Outcome from Western India

BACKGROUND: Hemiplegia/hemiparesis denotes the weakness of one side of the body. In contrast to adults, hemiparesis in children occurs secondary to a variety of etiological conditions. AIMS: The aim of this study was to assess the clinical, laboratory, and radiological features of children with acquired hemiparesis/hemiplegia of nontraumatic origin and intended to find its underlying etiology in the Indian children. SETTINGS AND DESIGN: This prospective, observational study was carried out at a tertiary care hospital in western India. MATERIALS AND METHODS: Children aged between 3 months and 14 years admitted to the in-patient department of a tertiary care hospital with acquired hemiparesis/hemiplegia were included over 2 years. Children with perinatal insult, preexisting neurological diseases, neurotrauma, hemiplegic migraine, and Todd's paralysis were excluded from the study. Detailed clinical examination, laboratory, and radiological investigations were done, and an attempt was made to find the underlying etiology. These children were also followed up after 1 month of discharge to look at short-term outcomes. All clinical information was recorded in a predesigned performa and was managed with Microsoft Excel spreadsheet. Frequency was presented as number (N) and percentage (%). RESULTS: Fifty-five children (male:female = 1.2:1), predominantly between 1 and 5 years of age were studied. Apart from weakness (92.8%), vomiting (70.9%), fever (58.2%), and seizure (58.2%) were the predominant presenting complaints. One-fifth of them had comorbidities; most commonly congenital heart disease. Cerebral infarction was the most common pathology in neuroimaging. Central nervous system infection (45.5%) was the most common identified etiology followed by vascular events (21.8%). Among those who could be followed up at 1 month, about 65% had some improvement in their power. CONCLUSION: Infections continue to be an important cause of neurodisability in the developing countries.