Forms of hemiplegia

Traditionally, hemiplegia or hemiparesis, is defined as a central unilateral palsy that only affects one side of the body, almost always of spastic type (Aicardi and Bax 2009), while the word hemidystonia is more adequately used to define the dyskinesic form. With respect to cerebral palsy (CP), a distinction is made between a congenital form of hemiplegia, when the lesion occurs before the end of the neonatal period (within the first four weeks of life), and an acquired form, when the lesion provoking hemiplegia occurs later, within the first three years of life. According to the main case studies published (Hagberg and Hagberg, 2000), congenital forms amount to 70-90% of childhood hemiplegia, while acquired forms only amount to 10-30%. In a recent review conducted by the SCPE (Surveillance of Cerebral Palsy in Europe) working group, the prevalence of unilateral spastic hemiplegia accounted for about 0.6 per 1000 live births and it did not change significantly over time (Krägeloh-Mann, 2009). Hemiplegic forms are the most common expression of CP (more than 38% of cases) and the second in terms of frequency, after diplegia, in premature infants (around 20% of cases) (Hagberg et al. 1996; Himmelmann et al. 2005). © 2010 Springer-Verlag Milan

Recommendations for the rehabilitation of children with cerebral palsy

The SINPIA-SIMFER(Italian Society of Child and Adolescent Neuropsychiatry-Italian Society of Physical Medicine and Rehabilitation) Intersociety Commission was set up in December 2000 and is composed of members from both scientific societies, who are experts in the field of rehabilitation of patients with cerebral palsy (CP). In accordance with the indications of the Italian Health Ministry's Planning Department, in 1999 this Commission was entrusted with the task of drawing up "Guidelines for the Rehabilitation of Children Affected by Cerebral Palsy", and to successively revise and update it every five years. The present document is a summary of the latest update, drawn up through meetings of the Intersociety Commission, held in 2012 and 2013, and discussed and approved at the annual SINPIA-SIMFERmeeting held in Brindisi in October 2013. The current version of the Recommendations extends and updates the previous one, also addressing new areas of intervention and adding some in-depth analysis. The document as a whole is not so much a proposal for treatment updated on the basis of advancing knowledge in the field of rehabilitation of CP, as a presentation of the method that should be applied by professionals seeking to define the most appropriate intervention and treatment strategies. The text is the offspring of a process of careful exchanges, which have been conducted in a collegial and collaborative fashion among professionals working in different fields (rehabilitation medicine and child neuropsychiatry) and in healthcare settings at different levels (ranging from first-level local settings to third-level national ones) and of different types (affiliated outpatient clinics and centers, local health authorities, hospitals, "IRCCS" research hospitals, universities)