Assessment tools
There are a variety of standardized assessment scales available to physiotherapists and other health care professionals for use in the ongoing evaluation of the status of a patients hemiplegia. The use of standardized assessment scales may help physiotherapists and other health care professionals during the course of their treatment plant to:
Prioritize treatment interventions based on specific identifiable motor and sensory deficits
Create appropriate short- and long-term goals for treatment based on the outcome of the scales, their professional expertise and the desires of the patient
Evaluate the potential burden of care and monitor any changes based on either improving or declining scoresSome of the most commonly used scales in the assessment of hemiplegia are:

The Fugl-Meyer Assessment of sensorimotor function (FMA)The FMA is often used as a measure of functional or physical impairment following a cerebrovascular accident (CVA). It measures sensory and motor impairment of the upper and lower extremities, balance in several positions, range of motion, and pain. This test is a reliable and valid measure in measuring post-stroke impairments related to stroke recovery. A lower score in each component of the test indicates higher impairment and a lower functional level for that area. The maximum score for each component is 66 for the upper extremities, 34 for the lower extremities, and 14 for balance. Administration of the FMA should be done after reviewing a training manual. The Chedoke-McMaster Stroke Assessment (CMSA)This test is a reliable measure of two separate components evaluating both motor impairment and disability.
There is tentative evidence of an association with undiagnosed celiac disease and improvement after withdrawal of gluten from the diet.Other causes of hemiplegia in adults include trauma, bleeding, brain infections and cancers. Individuals who have uncontrolled diabetes, hypertension or those who smoke have a higher chance of developing a stroke. Weakness on one side of the face may occur and may be due to a viral infection, stroke or a cancer. Common
Vascular: cerebral hemorrhage, stroke, cerebral palsy
Infective: encephalitis, meningitis, brain abscess, cerebral palsy, spinal epidural abscess
Neoplastic: glioma, meningioma, brain tumors, spinal cord tumors
Demyelination: multiple sclerosis, disseminated sclerosis, ADEM, neuromyelitis optica
Traumatic: cerebral lacerations, subdural hematoma, epidural hematoma, cerebral palsy, vertebral compression fracture
Iatrogenic: local anaesthetic injections given intra-arterially rapidly, instead of given in a nerve branch. Ictal: seizure, Todds paralysis
Congenital: cerebral palsy, Neonatal-Onset Multisystem Inflammatory Disease (NOMID)
Degenerative: ALS, corticobasal degeneration
Parasomnia: sleep paralysis

Mechanism
Movement of the body is primarily controlled by the pyramidal (or corticospinal) tract, a pathway of neurons that begins in the motor areas of the brain, projects down through the internal capsule, continues through the brainstem, decussates (or cross midline) at the lower medulla, then travels down the spinal cord into the motor neurons that control each muscle. In addition to this main pathway, there are smaller contributing pathways (including the anterior corticospinal tract), some portions of which do not cross the midline.Because of this anatomy, injuries to the pyramidal tract above the medulla generally cause contralateral hemiparesis (weakness on the opposite side as the injury).