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Hemiparesis treatment options
My fiance suffered a severe TBI in November 2007 with diffuse axonal injury and left hemiparesis with severe spasticity to the left arm and wrist.  For the arm, we have tried serial casting and botox with limited results.  We are being advised to pursue tendon lengthening so we can straighten out the wrist to reach the goal of having the ability to start weight bearing in the left arm. At present there is feeling in the left arm, but no muscle strength and no active movement.  Are there other things that can promote stimulating the muscles in hopes to regain function other than just weight bearing, such as electronic stimulation?  The same question would also apply to the left leg, which has some very limited active movement (ie, muscles activate during standing and sometimes the large toe can be moved - also, leg reacts to pain stimuli and pulls away from the pain, but active motion isn't consistent and sometimes its merely reflexes).  
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563773 tn?1374250139
Hello,

I feel that the best treatment is hope.It can move mountains.

Some of the treatment that you have mentioned are the standard treatments for hemiparesis.One treatment that is coming up is cortical stimulation (electrical stimulation to the area of the brain known  as the cortex), to see if this can improve arm and hand movement. The procedure is done by placing a tiny electrode on the tough membrane covering the brain (the dura). The electrode sends an electrical current to the brain while a patient undergoes rehabilitation exercises. Currently, this type of therapy is only targeted toward patients who have some movement in their wrists and fingers.  

Other techniques useful are Motor Imagery (MI) and Modified constraint-induced therapy (mCIT). When people imagine themselves using a certain body part, areas of the brain and muscles can be activated as if the person is actually doing the activity. This practice may improve arm movement in people with hemiparesis. It has also been suggested that MI may be useful in helping people walk.

Overall treatment of hemiparesis requires co ordination from physiatrists, Physical therapists and Occupational therapists.

You can find useful information from the following website:
http://www.stroke.org/site/PageServer?pagename=hemiparesis

Hope it helps.Take care and pls do keep me posted on how your fiancé is doing.

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