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What is spastic hemiparesis in children?

Q: The eldest of my three sons - all premature and normal delivery - has three major problems. He is 5 years old and has normal height and weight. He is a left-hander and his right side is a bit weak. He keeps his right hand half folded and needs to be persuaded to keep it down and firm. Same is the case with his head movement. His eyeballs too are not proper and seem to have squint particularly when he gets ill and weak. The third problem is that he drools profusely so much so that we have to tie a bib almost always. Apart from these, he is quite normal. His memory is very sharp, he is doing well in his class and his voice-delivery is fantastic regarding pronunciation. His left-handed punches are quite powerful and he wrestles well. All the doctors consulted say that he is quite normal and lacks only in calcium. An eye specialist after thorough check-up suggested that in course of time it will get normal. But we are scared. My two others sons are doing very well. Please advise.

A:From the brief information that I have, I can infer that your child who was born preterm has a right spastic hemiparesis (weakness of the right leg and arm with stiffness or spasticity). This is likely to have resulted from a stroke at the time of birth. This is unlikely to worsen. But it is important to assess: 1) Development - is his mental development appropriate for his age; 2) The cause of this deficit needs to be determined by a CT scan or MRI brain; 3) He requires good physiotherapy and no massage; 4) There is a good chance that some improvement can be brought about in his arm position and leg position with BOTOX injections which are administered at centres which are trained to do it. In Delhi, AIIMS and Sir Ganga Ram Hospital are performing this procedure.

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