When comparing congenital hemiplegia and acquired hemiplegia, a case of hemiplegia is considered congenital if  “hemiplegia onsets before birth, during birth, or within the first 2 years of life.” If a person becomes hemiplegic later in life, then it is considered a case of acquired hemiplegia.

In other words, the major difference between congenital and acquired hemiplegia is the timing of the condition.