Aetiology of Acute Hemiplegia in Childhood

Abstract

The syndrome of acute hemiplegia in childhood is defined, and the most popular theories of aetiology are critically examined. The frequency of preceding throat infection is stressed, and attention is also drawn to similarities of the syndrome to that of internal carotid disease in later life. Arteriography was carried out bilaterally in 15 cases, and on careful comparison of the two sides it was shown that in those cases examined sufficiently early, partial occlusion, constriction, or irregularity of the internal carotid artery and its main branches could be demonstrated on the affected side, the other being normal. Similar appearances were found in children with traumatic lesions of the carotid artery behind the tonsillar fossa, and also in carotid arteries closely related to infected cervical glands. It is suggested that in a high proportion of these cases there is an inflammatory carotid arteritis in the neck, with intimal damage, peripheral embolization, and cerebral lesions ranging from transient ischaemia to frank infarction. The possibilities for prevention of disability are briefly discussed. © 1964, British Medical Journal Publishing Group. All rights reserved.