Cases of acute hemiparesis in childhood

Abstract

Introduction: Acute hemiparesis is an emergency of various etiologies and possible fatal outcome. Aim: The aim of this study was to determine the etiology, clinical manifestations, and prognosis of acute hemiparesis in childhood. Materials and methods: This is a retrospective study of 52 children (28 boys and 24 girls) aged 4 months to 16 yrs 11 months with acute hemiparesis, admitted to the Clinic of Pediatrics at St George University Hospital between 2013 and 2020. After clinical examination, a modern diagnostic and therapeutic approach was used. Results: The identified causes of acute hemiparesis were ischemic stroke (21), postictal paresis after seizure (9), hemorrhagic stroke (6), venous sinus thrombosis (5), encephalitis (3), transient ischemic attacks (TIAs) (2), posterior reversible encephalopathy syndrome (PRES) (2), hemiplegic migraine (1), demyelinating CNS disease (1), ventriculoperitoneal shunt complication (1), glutaric aciduria type 1 (1), brain tumor (1), and CNS metastasis (1). The most common manifestations associated with acute hemiparesis were impaired consciousness (27), involvement of cranial nerves – central (25) and peripheral (1) facial nerve palsy, abducens (1), ocolomotorius (1), hypoglossus (1) nerve palsy, seizures (25), raised intracranial pressure (18), speech disorders (15), signs of infection (14), headache (12), and hemibody sensory disturbances (9). In 8 children (14%), the hemiparesis was permanent, in 2 recurrent, and in 7 (12%) fatal. Conclusions: Unlike in adult patients, acute hemiparesis in children has many causes, which requires a large number of etiological studies. With a quick diagnosis and adequate treatment, recovery of function in children is more common than in adults – it is achieved in two thirds of children.