These two terms are often used in discussions about attention and perception, particularly after neurological events like a stroke or brain injury. However, while they can sometimes overlap, they represent distinct challenges in how the brain processes visual information.

In this article, we’ll explore visual neglect and inattention—what they are, how they differ, and practical steps individuals can take to manage these conditions.

What is Visual Inattention? The Scattered Spotlight

Imagine your attention as a spotlight. Normally, you can direct this spotlight wherever you need it – focusing on a specific object, a conversation, or a task at hand. Visual inattention, also sometimes referred to as visual attentional deficits, is like having a scattered or unstable spotlight.

With visual inattention, the individual has difficulty focusing and sustaining their attention on visual stimuli. They might:

• Miss details: They might scan a scene but fail to notice important elements, like a word in a sentence or a face in a crowd.
• Be easily distracted: External stimuli, like a noise or movement in their peripheral vision, can easily pull their attention away from what they were initially focused on.
• Have trouble filtering information: They might struggle to ignore irrelevant visual information and focus on what’s important.
• Show inconsistent performance: Their ability to notice things might fluctuate depending on their level of alertness, motivation, or the complexity of the visual environment.

Think of it like trying to read a book in a busy coffee shop. The surrounding conversations, the clinking of cups, and the movement of people can all pull your attention away from the text, making it harder to concentrate and understand. For someone with visual inattention, this struggle can be amplified and more persistent, even in less distracting environments.

What is Visual Neglect? The Ignored Half of the World

Visual neglect, on the other hand, is a more profound and often more debilitating condition. Unlike inattention, which is a problem with focusing, neglect involves a lack of awareness of stimuli on one side of the visual field – even though the eyes themselves are perfectly capable of seeing.

Imagine your visual world divided into two halves – left and right. For someone with visual neglect, it’s as if one of these halves simply doesn’t exist.

For example, they might:

• Fail to notice objects on the affected side: This can range from not seeing food on one side of their plate to bumping into doorways or people on their neglected side.
• Not respond to stimuli on the affected side: If someone speaks to them from their neglected side, they might not turn their head or acknowledge them.
• Only draw or copy one side of an image: When asked to draw a clock, for example, they might only draw the numbers on the right side.
• Read only one side of a page: They might start reading in the middle of a sentence or only read the words on the non-neglected side.
• Neglect one side of their own body: In severe cases, they might even forget to groom or dress the neglected side of their body.

The key difference here is that with visual neglect, the information from the affected visual field isn’t even being processed by the brain in a way that leads to awareness. There is evidence that many cases of visual neglect also involve multisensory aspects, particularly auditory deficits. It’s not just a matter of difficulty focusing. It’s as if that part of the visual world has been erased from their conscious experience.

Visual Neglect vs Inattention Key Differences

To make the distinction clearer, let’s use a simple analogy:

Visual Inattention: Imagine a spotlight that keeps flickering and jumping around, making it hard to keep it focused on one thing. The information is there, but the spotlight isn’t steady enough to illuminate it consistently.

Visual Neglect: Imagine a blind spot in your vision. No matter how hard you try to focus, you simply cannot see what’s in that area. The information isn’t even reaching your conscious awareness.

Here’s a table summarizing the key differences:

What Causes Visual Neglect vs Inattention?

Both visual inattention and neglect are often the result of a neurological injury, most commonly stroke. Other injuries such as TBI, tumors, and other neurological conditions can also cause visual neglect and inattention. 

Generally, the specific areas of the brain affected for visual neglect vs inattention tend to differ. This leads to the different symptoms and presentation for each.

Visual inattention is often associated with damage to the frontal and parietal lobes, which play crucial roles in attention control, executive functions, and the filtering of information. Damage to these areas can disrupt the brain’s ability to direct and maintain focus on visual stimuli.

Conversely, visual neglect is most commonly linked to damage in the posterior parietal lobe, particularly in the right hemisphere. This area is critical for spatial awareness and the representation of space. Damage here can disrupt the brain’s ability to process information from the contralateral (opposite) side of the body and visual field. Right hemisphere damage often leads to left-sided neglect, which is more common and often more severe than right-sided neglect.

It’s important to note that there can be overlap, and an individual might experience both inattentive tendencies and some degree of neglect, especially in the acute stages after a brain injury.

Living with Visual Inattention and Neglect: Challenges and Adaptations

Living with visual inattention or neglect can significantly impact daily life. For example, imagine trying to navigate a crowded street when you constantly miss people walking on one side or trying to read an email when your attention keeps drifting away.

Here is an overview of some challenges individuals with visual inattention or neglect may face.

Visual Inattention Challenges May Include:

• Difficulty with tasks requiring sustained visual focus, such as reading, writing, or computer work.
• Increased risk of errors and accidents due to missed details.
• Challenges in social situations due to difficulty following conversations and noticing non-verbal cues.
• Frustration and fatigue due to the constant effort required to maintain focus.

Visual Neglect Challenges May Include:

• Difficulties with basic self-care activities like eating, dressing, and grooming the neglected side of the body.
• Increased risk of falls and collisions due to a lack of awareness of obstacles on the neglected side.
• Challenges with navigation and mobility in both familiar and unfamiliar environments.
• Difficulties with reading and writing, often leading to significant communication challenges.
• Social isolation due to difficulties interacting with others and navigating social situations.

Despite these challenges, individuals with visual inattention and neglect can learn to adapt and improve through various rehabilitation strategies.

Visual Neglect vs Visual Inattention Rehabilitation and Management: Retraining the Brain 

The good news is that the brain has a remarkable capacity for recovery and adaptation, a concept known as neuroplasticity. While complete recovery may not always be possible, various therapeutic interventions can help individuals with visual inattention and neglect improve their awareness and function.

Let’s take a look at some strategies you can use to manage or improve both visual inattention and neglect.

Rehab and Management Strategies for Visual Inattention

Attention Training Exercises: These exercises aim to improve sustained, selective, and divided attention through tasks that gradually increase in complexity.

Environmental Modifications: Reducing distractions and organizing the environment can help minimize attentional demands.

Compensatory Strategies: Using techniques like verbal self-instruction, scanning strategies, or visual cues to help maintain focus.

Medication: In some cases, medication may be used to address underlying attentional deficits.

Rehab and Management Strategies for Visual Neglect

Visual Scanning Training: Encouraging systematic scanning of the neglected side by providing visual cues and feedback.

Prism Adaptation: Using prism glasses that shift the visual field to the non-neglected side, which can temporarily improve awareness of the neglected side and have lasting effects.

Limb Activation Therapy: Encouraging movement of the limb on the neglected side to increase awareness of that side of the body and space.

Environmental Adjustments: Placing important items on the non-neglected side initially and gradually encouraging scanning to the neglected side.

Virtual Reality Therapy: Offering immersive and engaging environments to practice scanning and navigation skills.

Researchers are continuing to examine which methods are most effective for treating visual inattention and neglect. For anyone experiencing visual inattention or neglect, it’s helpful to work with your care team of specialists. These professionals can help create a personalized rehab plan just for you!

Living With Visual Neglect and Inattention: Final Thoughts

Visual inattention and visual neglect are distinct but related conditions that can significantly impact an individual’s ability to perceive and interact with the world around them. While both involve challenges with visual processing, inattention is primarily a difficulty with focusing attention, while neglect involves a lack of awareness of one side of the visual field.

Understanding these differences is critical to effective rehabilitation and providing appropriate support to individuals living with these conditions. If you or someone you know is experiencing difficulties with attention or seems unaware of one side of their environment, it’s essential to seek professional medical advice. Early diagnosis and intervention can make a significant difference in improving quality of life and fostering greater independence. 

The brain is amazing and can bounce back in incredible ways. With the right support and strategies, individuals with neglect or inattention can find new ways to navigate the world and keep moving forward.

The post Seeing What’s Not There (or Missing What Is): Understanding Visual Neglect vs. Inattention appeared first on Flint Rehab.

This guide will help you understand what signs of decline you need to look out for following a stroke. Plus, we will also take a look at some of the different resources and support options for recovery.

Let’s dive in!

Understanding the Aftermath of a Stroke

Strokes affect everyone differently. Some individuals may experience mild, temporary effects, while others may face severe, long-term disabilities.

The extent of the impact of a stroke depends on a variety of factors including:

• Stroke type: Strokes are primarily categorized as ischemic (caused by a blood clot blocking an artery) or hemorrhagic (caused by a blood vessel rupturing and bleeding into the brain). Hemorrhagic strokes are generally more severe.
• Location and extent of brain damage: The specific brain regions affected and the severity of the damage influence the type and extent of resulting impairments. For example, damage to the left side of the brain often affects language and speech, while damage to the right side may impact spatial awareness and perception.
• Overall health and pre-existing conditions: Age, medical history, lifestyle factors (such as smoking, physical fitness and diet), and pre-existing conditions like diabetes or heart disease can influence stroke recovery and the likelihood of decline.
• Access to timely and effective treatment: The speed at which a stroke is diagnosed and treated significantly impacts the extent of brain damage. Early recognition and intervention with clot-busting medications or surgery, followed by comprehensive rehabilitation, is crucial for maximizing recovery and minimizing long-term effects.

While many individuals will experience improvements with time and dedicated rehabilitation, some may face a decline in their condition. While declining after stroke can be cause for concern, occasional minor setbacks are expected throughout the recovery process. 

Let’s take a look at some of the signs of decline after stroke.

Physical Signs of Decline After Stroke

Physical decline after a stroke can manifest in various ways, impacting motor skills, sensory perception, and basic bodily functions. Here are some examples of physical signs of decline after stroke that you should be on the look out for.

1. Worsening Motor Skills

Worsening motor skills can be a sign of decline after stroke. Some of the most common issues may include:

• Increased weakness or paralysis: This might involve a decreased ability to move limbs, maintain balance, or coordinate movements. Individuals may experience difficulty walking, standing, or performing tasks that require fine motor control.
• Changes in gait: Changes in walking patterns, such as shuffling, unsteadiness, or frequent falls, can indicate a decline in motor control and balance. This can significantly increase the risk of injuries.
• Difficulty with fine motor skills: Tasks requiring precise movements, like buttoning clothes, writing, or using utensils, may become more challenging. This can affect an individual’s independence and ability to perform daily activities.
• Spasticity: Increased muscle stiffness and tightness can lead to pain, reduced range of motion, and difficulty with movement. Spasticity can also contribute to contractures, where muscles become permanently shortened. However, spasticity can also be a sign of recovery after stroke.
• Learned nonuse: When motor deficits result in difficulties using a limb for everyday activities, survivors may be tempted to avoid using that limb. For example, if a survivor has spasticity in their right hand, they may begin using only their left hand for daily tasks such as eating and brushing their teeth. Avoiding use of their affected right hand can cause any remaining function in that hand to deteriorate. To combat this, it is important to continue to try to use affected limbs, even if it is challenging.

You can utilize these full body stroke exercises to help improve worsening motor skills following a stroke.

2. Changes in Sensory Perception

Another common physical sign of decline after stroke may include changes in sensory perception such as:

• Vision problems: Stroke can affect vision in various ways, including blurred vision, double vision, loss of peripheral vision, or even complete blindness in one or both eyes.
• Numbness or tingling: Decreased sensation or altered sensations, such as numbness, tingling, or “pins and needles,” can occur in the areas affected by the stroke.
• Pain: Stroke survivors may experience persistent headaches, muscle aches, nerve pain (neuropathic pain), or pain related to spasticity.
• Difficulties with spatial awareness: Problems with judging distances, navigating surroundings, or perceiving the position of their body in space can make it challenging to move around safely and perform daily tasks.

Here, sensory reeducation can be an important piece of recovery for continued improvement.

3. Communication Challenges

Communication challenges can be frustrating following a stroke. Some common signs of decline after stroke may include:

• Worsening aphasia: Aphasia, a language disorder, can affect speaking, understanding language, reading, and writing. A decline in communication abilities can lead to frustration, social isolation, and difficulty expressing needs and wants.
• Dysarthria: Dysarthria refers to difficulty with speech articulation due to muscle weakness or coordination problems. This can result in slurred or mumbled speech, making it challenging for others to understand.
• Cognitive changes: Cognitive decline, including problems with memory, attention, and problem-solving, can further complicate communication and make it difficult to follow conversations or express thoughts clearly.

To improve your communication following a stroke, cognitive and speech therapy are key.

4. Swallowing Difficulties

Another sign of decline after stroke may include swallowing difficulties.

• Dysphagia: Dysphagia, or difficulty swallowing, can lead to choking, coughing, and aspiration (food or liquid entering the lungs). Aspiration can cause serious complications like pneumonia.
• Weight loss or malnutrition: Difficulties with eating and drinking can result in inadequate nutrition and weight loss, further compromising health and recovery.
• Dehydration: Swallowing problems can also lead to dehydration, which can cause fatigue, confusion, and other health issues.

Here are 10 Swallowing Exercises for Stroke Patients to Recover from Dysphagia that you can utilize during your recovery journey.

5. Fatigue and Reduced Energy Levels

One of the more frustrating signs of decline after stroke can be the fatigue and reduced energy levels. Some examples may include:

• Persistent tiredness and lack of motivation: Stroke survivors often experience persistent fatigue and lack of energy, even after minimal exertion. This can make it challenging to participate in rehabilitation and daily activities.
• Difficulty concentrating or staying awake: Fatigue can also affect cognitive function, making it difficult to concentrate, stay focused, and participate in conversations or activities.
• Sleep disturbances: Stroke can disrupt sleep patterns, leading to insomnia, excessive daytime sleepiness, or frequent awakenings during the night.

You can learn more about the causes and management of fatigue after stroke here.

6. Incontinence

Finally, incontinence can be one of the more clear and embarassing signs of decline after stroke.

• Loss of bladder or bowel control: Incontinence can be a distressing and embarrassing problem for stroke survivors, impacting their self-esteem and quality of life.
• Urinary tract infections (UTIs): Incontinence increases the risk of developing urinary tract infections, which can cause further health complications.
• Pressure ulcers: Stroke survivors, especially those with paralysis, face a heightened risk of pressure ulcers. When lack of movement is combined with incontinence, the chances of developing a pressure ulcer are even higher.

While it may be uncomfortable or embarassing, remember that continuing to focus and work on your recovery is the best way to manage it and improve your quality of life.

Cognitive and Emotional Signs of Decline After Stroke

Stroke can also significantly impact cognitive abilities and emotional well-being, leading to challenges in memory, mood, and social interaction. Here are some cognitive and emotional signs of decline after stroke.

1. Memory Problems

Memory problems are a common issue for stroke survivors. Oftentimes, it can impact the ability to navigate everyday life and maintain a sense of independence. Some signs of memory problems may include the following.

• Difficulty recalling recent events or information: This can affect daily routines, conversations, and the ability to learn new information.
• Short-term memory loss: Forgetting appointments, names, or instructions can make it challenging to manage daily life and maintain independence.
• Confusion or disorientation: Stroke survivors may experience confusion about their surroundings, time, or identity. They may also struggle to recognize familiar places or people.

Cognitive therapy and utilizing memory aids can be an important piece of the recovery journey here.

2. Changes in Mood and Behavior

Changes in behavior and mood are another sign of decline after stroke. These can vary and include symptoms like:

• Depression: Feelings of sadness, hopelessness, loss of interest in activities, and changes in appetite or sleep are common after a stroke. Depression can significantly impact recovery and quality of life.
• Anxiety: Excessive worry, nervousness, and fear can be triggered by the stroke itself, the challenges of recovery, or concerns about the future.
• Emotional lability: Sudden and uncontrolled mood swings, including crying or laughing inappropriately, can be challenging for both the stroke survivor and their loved ones.
• Irritability or agitation: Increased frustration, anger, or restlessness can be a sign of underlying cognitive or emotional difficulties.
• Personality changes: Stroke can sometimes lead to subtle or significant changes in personality, affecting relationships and social interactions.

Check out our recent article to learn how to better deal with changes in mood and behavior after stroke.

3. Reduced Cognitive Abilities

Reduced cognitive abilities can sometimes be difficult to diagnose depending on severity. However common signs can include:

• Difficulty with problem-solving or decision-making: Stroke survivors may struggle with complex tasks, planning, or making decisions, impacting their ability to manage their lives independently.
• Slowed processing speed: Taking longer to understand information, process thoughts, or respond to questions can affect communication and daily functioning.
• Decreased attention span: Difficulty concentrating or staying focused can make it challenging to participate in conversations, complete tasks, or follow instructions.
• Post-stroke dementia: Individuals have a 3 times greater risk of developing dementia in the first year after stroke. In fact, having a stroke increases the risk of future dementia by 80%. Those with dementia may experience further cognitive decline and behavioral changes.

Cognitive therapy can help you track and improve here which can be an important part of continued improvements.

4. Social Withdrawal and Isolation

Finally, social withdrawal and isolation after stroke can be a sign of decline. This includes:

• Loss of interest in social activities: Stroke survivors may withdraw from social activities due to physical limitations, communication difficulties, fatigue, or emotional challenges.
• Difficulty communicating: Aphasia or other communication problems can lead to frustration and social isolation, making it difficult to connect with others.
• Decreased self-esteem: Changes in physical appearance, functional abilities, or cognitive skills can affect self-esteem and confidence, leading to social withdrawal.

Although you may not be able to do all the same activities you could before, new activities and hobbies can provide a novel way to challenge your brain.

Recognizing the Warning Signs of Post Stroke Decline

It’s important to remember that not all changes after a stroke indicate a decline. Some fluctuations in abilities and mood are a normal part of the recovery process. However, if you notice any of the following warning signs, it’s crucial to seek medical attention promptly:

• Sudden worsening of existing symptoms: A significant and rapid increase in weakness, speech difficulties, cognitive problems, or other existing symptoms.
• New symptoms: The development of new physical or cognitive challenges, such as seizures, vision loss, severe headaches, or loss of consciousness.
• Changes in behavior or personality: Increased confusion, agitation, withdrawal, or uncharacteristic behavior.
• Decline in overall functional abilities: A noticeable decrease in the ability to perform daily tasks, participate in activities they previously enjoyed, or maintain personal hygiene.
• Increased falls or accidents: Frequent falls, injuries, or accidents can indicate a decline in motor skills, balance, or cognitive function.
• Changes in eating or drinking habits: Difficulty swallowing, loss of appetite, or changes in fluid intake can lead to malnutrition and dehydration.
• Worsening of incontinence: Increased frequency of accidents or difficulty managing bladder or bowel control.
• Signs of infection: Fever, increased fatigue, changes in mental status, or localized pain or redness can indicate an infection, which can be particularly serious in stroke survivors.

While a functional decline may occur as a result of stroke-related complications, it may also occur due to unrelated factors. This can include things like a new or worsening medical condition or unexpected circumstances. For example, if an individual experiences a heart attack, car accident, or the death of a loved one.

Options for Help and Support

If you or a loved one experiences signs of decline after a stroke, it’s essential to seek medical attention promptly. Early intervention can help identify the underlying causes of the decline and lead to appropriate treatment and support.

Here are some key resources that can provide guidance and assistance after a stroke:

• Your primary care physician or neurologist: They can provide medical advice, conduct assessments, order tests, and coordinate care with other specialists.
• Rehabilitation specialists: Physical therapists, occupational therapists, and speech-language pathologists can help improve functional abilities, address specific challenges, recommended adaptive strategies, and develop personalized rehabilitation plans.
• Registered dietitians: Can provide guidance on dietary modifications and strategies for managing swallowing difficulties and ensuring adequate nutrition after a stroke.
• Psychologists and counselors: Can offer support for emotional and mental health concerns, including depression, anxiety, and adjustment to life after a stroke.
• Support groups: Connecting with other stroke survivors and caregivers can provide emotional support, practical advice, and a sense of community. Check with your local hospital or use this link from the American Stroke Association to find a stroke support group near you.
• AmericanStroke Association: Offers a wealth of information, resources, support programs, and research on stroke prevention and treatment for stroke survivors and their families. (www.stroke.org)

Proactive Steps for Long-Term Well-being

One of the best ways to prevent decline after stroke is to actively pursue recovery. It is essential to practice using your affected functions on a daily basis – whether improving physical, cognitive, or emotional skills. This stimulates neuroplasticity, or the brain’s ability to adaptively rewire itself.

While some decline after a stroke is unavoidable in certain cases, there are steps you can take to promote long-term well-being. These include:

• Adherence to medication and treatment plans: Following medical advice meticulously, taking medications as prescribed, and attending all scheduled appointments are crucial for managing stroke-related conditions and preventing further complications.
• Regular check-ups and monitoring: Regular visits with your healthcare team allow for ongoing monitoring of your condition, early detection of any changes, and adjustments to your treatment plan as needed.
• Healthy lifestyle choices: Maintaining a balanced diet, engaging in regular physical activity (as appropriate for your abilities), avoiding smoking, and limiting alcohol consumption can significantly improve overall health and reduce the risk of future strokes.
• Cognitive and physical rehabilitation: Continuing and staying consistent with stroke rehabilitation therapies, even after formal programs have ended, can help maintain functional abilities, improve cognitive skills, and prevent further decline.
• Emotional and social support: Staying connected with loved ones, participating in support groups, and seeking professional help for mental health concerns are crucial for emotional well-being and overall quality of life.
• Brain health activities: Engaging in mentally stimulating activities, such as reading, puzzles, learning new skills, and social interaction, can help maintain cognitive function and promote brain health.
• Stress management: Practicing stress management techniques, such as mindfulness, meditation, or deep breathing exercises, can help reduce anxiety, improve mood, and promote overall well-being.

Approaching Signs of Decline After a Stroke

Recognizing the signs of decline after a stroke is essential for ensuring timely intervention and maximizing quality of life. Proactive steps, ongoing support, and a focus on overall well-being can help individuals navigate these challenges and live fulfilling lives.

Remember, you are not alone. Reach out to your healthcare team, connect with support networks, and embrace the resources available to you.

The post 10 Signs of Decline After a Stroke and What To Do About It appeared first on Flint Rehab.

In this guide we will explore some of the common emotional changes after a stroke. We will also take a look at some practical strategies for coping as well as finding support along your recovery journey.

Let’s dive in!

Jump to a section:
Understanding the Emotional Impact of Stroke
Common Emotional Changes After Stroke
Coping With Emotional Changes After Stroke
Tips for Family and Caregivers

Understanding the Emotional Impact of Stroke

The brain is the control center for our emotions. While there are many areas of the brain involved in regulating emotions, this responsibility is primarily attributed to the limbic system. Now, when a stroke occurs, it may disrupt neural pathways involved in emotional regulation which can lead to various emotional changes. 

However, while a stroke can directly damage areas of the brain involved in emotions, many individuals also experience a wide range of emotions simply due to the challenge of adjusting to life after stroke. In other words, learning to cope with the physical and cognitive aftermath of stroke may be an emotional journey, even if the areas of the brain related to emotional regulation are undamaged. 

Let’t take a look at some of the common emotional changes following a stroke.

Common Emotional Changes After Stroke

Depression

It’s not unusual to feel persistent sadness, hopelessness, or loss of interest in activities you once enjoyed after a stroke. This is a common emotional reaction to the challenges and losses associated with stroke. In fact, one-third of all stroke survivors experience post-stroke depression at some point. 

Anxiety

Post-stroke anxiety is about as common as post-stroke depression, with approximately one-third of all survivors experiencing anxiety in the first year following their stroke. This may include  worries and fears about the future, your health, and your ability to regain independence. These anxious emotional changes after stroke are often linked to the uncertainties life after stroke can bring.

Emotional Lability

Also known as pseudobulbar affect (PBA), this involves sudden, uncontrollable outbursts of laughing or crying, often at inappropriate times. This condition arises from damage to the brain’s emotional control centers. It is estimated to affect up to 1 of 5 survivors in the beginning stages of stroke, and may still affect 1 of 8 survivors beyond 6 months post-stroke.

Irritability, Frustration, and Anger

Difficulties with communication, physical limitations, and adjusting to a new reality can understandably lead to increased irritability , frustration, and anger. These emotional changes are a natural response to the challenges of stroke recovery. 

Apathy

Following a stroke, some individuals may experience a lack of motivation, decreased interest in activities, and emotional withdrawal. This can be a symptom of depression or a separate consequence of the stroke.

Lack of Empathy

While not as common as some of the other emotional changes after stroke, some survivors have difficulties understanding the emotions of others. This may make survivors appear self-centered or uncaring, but it is often related to damage to specific brain areas, such as the right temporal pole and anterior insula.

Some individuals may experience minor emotional challenges after stroke, while others experience intense, persistent emotional changes. If emotional changes are impacting your day-to-day activities and interactions, talk with your doctor. They can further assess why these changes are occurring and recommend appropriate management or treatment strategies.

About 12% of stroke survivors experience suicidal ideation. If you or a loved one are having thoughts of suicide, please call or text 988 to reach the Suicide and Crisis Lifeline if you are in the US or your local emergency number.

Why Do These Changes Occur?

Although we have touched on a few of these reasons, there are a number of factors that contribute in varying ways to emotional changes after a stroke.

Some of these include:

• Brain Damage: The stroke itself can damage areas of the brain responsible for regulating emotions.
• Adjusting to Loss: A stroke often brings significant life changes, including physical limitations, loss of independence, and changes in social roles. These losses can be difficult to process.
• Post-Stroke Fatigue: Many survivors experience post-stroke fatigue, which may cause increased irritability or difficulties with emotional regulation.
• Medication Side Effects: Some medications prescribed after a stroke can have emotional side effects.
• Social Isolation: Difficulties with communication or mobility can lead to social isolation, which can further impact mood.

Coping with Emotional Changes after a Stroke

Navigating the emotional aftermath of a stroke can be challenging. However, there are strategies and resources to help you cope and regain emotional well being as you continue your recovery journey.

Let’s take a look at a few.

1. Acknowledge and Accept Your Feelings

To begin the healing process, don’t ignore or suppress your emotions. Acknowledge them as a natural part of the recovery process. Allow yourself to grieve the losses you’ve experienced and accept that it’s okay to feel a range of emotions.

This includes the more difficult emotions like anger, fear, and sadness. Don’t judge yourself for what you are feeling; simply allow yourself to experience it.

2. Seek Professional Support

To help you navigate this difficult time, it is important to seek professional support and resources including:

• Therapy: A therapist can provide a safe space to explore your feelings, develop coping mechanisms, and address specific emotional challenges like depression or anxiety. Cognitive-behavioral therapy (CBT) is often helpful in changing negative thought patterns.
• Support Groups: Connecting with other stroke survivors can provide a sense of community and understanding. Sharing experiences and learning from others can be incredibly validating. Use the American Stroke Association’s support group finder here to find a local stroke support group.

3. Communicate with Loved Ones

For emotional support, work on openly communicating your feelings with family and friends. Let them know how they can support you. Social isolation is common among stroke survivors. Sometimes, simply having someone to listen to your thoughts, emotions, and concerns can make a significant difference. 

It may take a little bit to feel comfortable with this but learn to be specific about your needs – whether it’s a shoulder to cry on, help with errands, or someone to accompany you to appointments. Clear communication can help your loved ones provide the most effective support.

4. Lifestyle Adjustments

Making positive lifestyle adjustments can significantly impact your emotional well-being. Some of the most common and simple lifestyle adjustment you can make include:

• Healthy Diet: Nourishing your body with a balanced diet can positively impact your mood and energy levels.
• Regular Exercise: Physical activity, even gentle exercises after stroke, can release endorphins, improve mood, and reduce stress.
• Quality Sleep: Aim for 7-8 hours of quality sleep each night. Establish a regular sleep schedule and create a relaxing bedtime routine.
• Stress Management: Practice relaxation techniques such as deep breathing, meditation, or yoga to manage stress and anxiety.  

5. Engage in Meaningful Activities

After a stroke, depending on the severity, you may find yourself unable to do some of the activities you once enjoyed. However, it’s crucial to rediscover joy and purpose by exploring new or adapted activities. 

This could involve spending time in nature, adapting old hobbies, learning new skills, or volunteering in your community. Even small activities can provide a sense of accomplishment and boost your mood, contributing to a more fulfilling life after stroke.

6. Medication Management

Sometimes  new medications can interfere with existing meds, causing an adverse reaction. If you suspect your medication is contributing to emotional changes, talk to your doctor. They may be able to adjust your dosage or prescribe a different medication.

However, absolutely do not make any changes to your medication or healthcare routine without first consulting your doctor.

Tips for Family & Caregivers Dealing With Emotional Changes After Strokes

Supporting a loved one through the emotional challenges after a stroke is crucial. If you are a caregiver or family member to someone that has just suffered a stroke, especially for a young adult, here are a few ways you can help them through this challenging time.

• Be Patient and Understanding: Recovery takes time. Be patient with your loved one as they navigate their emotions and adjust to their new reality.
• Remember Emotional Changes May be Beyond Their Control: Damage to the emotion center of the brain, as well as other areas, may be responsible for changes in your loved one’s emotions. They may still be relearning how to manage their emotions effectively.
• Offer Practical Support: To ease their burden, assist with daily tasks, transportation, and appointments. This can reduce stress and free up their energy to focus on emotional well-being.
• Encourage Social Interaction: Help your loved one stay connected with friends and family. Arrange visits, outings, or video calls.
• Educate Yourself: To better understand their experience, learn about the emotional effects of stroke so you can better understand what your loved one is going through.
• Seek Support for Yourself: Caring for a stroke survivor can be emotionally taxing. Don’t hesitate to seek support for yourself through therapy or support groups.

Emotional Changes After Stroke: The Long-Term Outlook

The emotional changes after a stroke can be significant, but they don’t have to define your future. Many stroke survivors experience these challenges, and with the right support, coping strategies, and professional help, regain emotional well-being and lead fulfilling lives.

By understanding the emotional impact of stroke and taking proactive steps towards recovery, you are taking the first step toward regaining a sense of control, rebuilding your life, and finding new meaning and purpose.

The post Emotional Changes After Stroke: A Complete Guide to Understanding and Coping appeared first on Flint Rehab.

This article will describe multiple types of behavior changes that survivors may demonstrate after stroke. Learning about potential behavior changes can help survivors and their families know what to expect and understand when it may be appropriate to seek further medical attention.

This guide has been updated to be as comprehensive as possible. Use the links below to jump straight to any section.

• Impulsive and inappropriate behavior
• Stubbornness
• Aggression
• Mood swings
• Depression
• Unusual behavior
• Neglectfulness
• Childlike behavior
• Hypo- and hypersexuality

Why Do Behavior Changes Occur After Stroke?

While gradual changes in behavior are common as individuals move through different life stages, a stroke can cause immediate, drastic changes. Some stroke survivors may demonstrate completely new personality traits and behaviors, which can surprise their loved ones. Fortunately, there are ways to help survivors overcome inappropriate or unwanted behaviors. But why do these changes happen to begin with?

Sudden behavior changes after stroke can be caused by changes in the brain. A stroke is a medical event that impacts the brain, causing damage to varying amounts of brain tissue. As a result, there may be changes in the brain that cause an abrupt change in behavior.

In fact, damage to certain areas of the brain affected by stroke can be directly correlated with behavior changes. For instance, a frontal lobe stroke may result in impulsivity because that area of the brain contributes to self-control.

On the other hand, slow, progressive behavior changes after stroke could simply be a result of adjusting to the lifestyle changes that often occur while coping with the secondary effects of stroke. An individual’s sense of personality and identity is often derived from things like friends, occupations, and hobbies. A stroke may disrupt the ability to participate in valued relationships and activities, leading to altered personality traits and behavior.

Types of Behavior Changes After Stroke

Every stroke is different, and life after stroke looks different for everyone. Behavior changes may affect some survivors greatly, while others may experience few, if any, behavior changes.

The following sections outline some of the most common behavior changes after stroke:

Irrational, Impulsive, or Inappropriate Behavior

Individuals may demonstrate irrational, impulsive or inappropriate behaviors when a stroke impacts executive functioning skills, which are necessary for planning and modulating behaviors. Working memory, organization, self-control, and decision-making skills are all considered part of the executive functions. Since executive functioning skills are housed in the frontal lobe, particularly in the prefrontal cortex, damage to this area can result in these types of behaviors.

Stubborn Behavior

Some individuals may demonstrate stubborn behavior after stroke. Identifying specific situations that the individual is being stubborn about is often the first step toward remedying this behavior. Does the survivor insist on doing things independently even though it is more difficult? This stubbornness is actually helpful for recovery as it provides stimulation for the brain and encourages improvement, as long as safety is not being compromised.

On the other hand, some survivors are stubborn about the effects of their stroke, potentially denying that anything is wrong. This could be a sign of a medical condition called anosognosia, or lack of insight.

In this case, individuals may be unaware that they have any stroke-related deficits. Therefore, they may refuse any assistance and continue participating in activities even when it is unsafe to do so. Survivors with anosognosia are not being intentionally stubborn. Rather, their stubborn behavior stems from changes in the brain that impair their ability to be self-aware.

Aggression

Aggressive behavior is especially common in the acute stage of stroke recovery. If individuals exhibit aggressive behavior, seek help by talking to their doctor and, if necessary, calling the domestic abuse hotline. Usually aggressive or combative behavior is the result of damage to the frontal lobe and impaired impulse control.

Therapy and medication may help reduce aggressive behavior. However, in order to obtain appropriate treatment, it is imperative for loved ones to talk with the survivor’s doctor while also protecting their own safety.

Mood Swings After Stroke

Behavior is closely linked with emotion. Therefore, some behavior changes after stroke can be connected to emotional changes, such as mood swings.

While mood swings may be directly related to the brain damage sustained during stroke, they may also be a result of adapting to the intense challenges of stroke recovery. Following a stroke, everyday activities may require more energy than normal as the brain is still healing. This can result in post-stroke fatigue, a condition which can make individuals more susceptible to mood swings.

When the emotion center of the brain is affected by stroke, conditions such as pseudobulbar affect, also known as emotional lability, may lead to mood swings. Pseudobulbar affect can cause uncontrollable emotional outbursts like excessive laughing or crying, which may or may not be appropriate to the situation. This condition may improve on its own or be treated with medication.

Depression

It’s estimated that one out of every three stroke survivors struggles with depression. Depression can have a significant impact on an individual’s behavior. For instance, depression may cause an individual to lack the motivation needed to pursue recovery. If this person was ambitious prior to their stroke, this can look like a change in behavior.

It is essential to address post-stroke depression, as it can have a detrimental effect on recovery. Treatments may include medication, psychotherapy, and lifestyle changes.

Strange Behavior

Some family members notice strange behavior in their loved ones after stroke, such as disorganized thoughts or actions that don’t seem to make sense. Unusual behaviors could be manifestations of a number of conditions, including post-stroke dementia.

Strange behaviors may also be seen as individuals adjust to living with stroke-related deficits, or they may be directly related to perceptual or cognitive changes after stroke. Family members who notice strange behaviors should start by discussing their concerns with the survivor, as they may have a valid explanation for their actions. If unresolved, consult with the survivor’s doctor, especially if there are concerns regarding their safety and well-being.

Forgetfulness and Neglectfulness

A stroke that affects cognitive skills, such as memory and attention, may cause individuals to act forgetful or neglectful. Since forgetfulness is often the result of impaired cognitive functions, it can improves over time with cognitive rehabilitation.

Neglectfulness, however, could be a sign of hemineglect, a condition where individuals do not notice things on their affected side. For example, individuals with left side neglect may not notice someone approaching them on their left side. While this may seem like a change in behavior, it’s actually a cognitive deficit that should be formally diagnosed and addressed.

Childlike Behavior

Some survivors demonstrate childlike behavior after stroke. This behavior may present in a number of ways, such as self-centeredness, impulsivity, or a lack of empathy.

While some survivors may use this behavior as a coping mechanism, it may also be a symptom of damage to the brain. When childlike behavior becomes extreme, it may be linked to vascular dementia or frontal lobe damage, so be sure to consult with a doctor for further evaluation.

Hypo- and Hypersexuality After Stroke

After a stroke, an individual’s libido can decrease or increase. Hyposexuality, or a decreased libido, is common after a stroke. This could be the result of the challenges of recovery, insecurities about physical abilities, or changes in the brain. Also, some medications, such as antidepressants, are known to decrease sex drive.

Other stroke survivors experience an increase in libido, known as hypersexuality. Although research on hypersexuality after stroke is limited, it is suggested that the condition may be associated with a stroke in the temporal lobe or potentially the basal ganglia.

Diagnosis and Treatment for Behavior Changes After Stroke

As seen above, there is a wide range of behavior changes that may occur after stroke, as well as many potential causes for these behaviors. Therefore, it is critical to discuss any changes in behavior with a doctor for a formal diagnosis.

Treatments for behavior changes after stroke may include:

• Medication. A number of pharmaceutical options are available to address changes in behavior, including mood stabilizers and antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are often used, and certain SSRIs may even help with behavior changes that stem from biological changes.
• Psychotherapy. Different types of psychotherapy, such as cognitive behavioral therapy, may be recommended to cope with and address behavior changes after stroke. When behavior changes are severe, other treatments may be used to supplement therapy. Regardless, psychotherapy often plays a strong role in recovery.
• Positive psychology. While psychotherapy attempts to address negativity, positive psychology aims to “enhance the good” by rewiring the brain for happiness. This practice is particularly helpful for post-stroke depression. The book, Healing & Happiness After Stroke, dives deeper into this concept.
• Cognitive rehabilitation. Frequently provided by a speech-language pathologist, cognitive rehabilitation involves practicing certain mental exercises to help encourage neuroplasticity and improve cognitive skills. Individuals that struggle with poor memory or post-stroke dementia can particularly benefit from this therapy. Programs such as the CT Speech & Cognitive Therapy App can also be used at home to enhance cognitive rehabilitation.
• Mindfulness and meditation. Being present in the moment by practicing mindfulness and meditation exercises may help with managing behavior changes after stroke. Especially helpful for impulsivity, taking time each day to be mindful can improve both emotional wellbeing and behavior.
• Healthy lifestyle choices. Being physically active and eating a balanced diet can play a role in mitigating behavior changes after stroke. By engaging in physical activity daily and eating foods that are known to boost recovery after stroke, survivors may begin to see positive changes.

While these treatments can promote recovery, it is also possible for spontaneous recovery to occur. However, it is usually best to be proactive about pursuing treatment, rather than waiting around for things to resolve on their own.

Survivors should consult with their doctors to learn more about which treatments may be most effective for targeting specific behavior changes after stroke. Starting with healthy habits like meditation and eating well can be a great first step toward recovery.

Understanding Behavior Changes After Stroke

There are many different ways that behavior can be affected after stroke. While behavior changes may occur as a direct result of stroke, alterations in behavior may also occur in response to difficulties coping with stroke-related changes.

Always talk to a doctor if there are concerns about certain behaviors after stroke. This can help survivors and their families get a clearer picture of what’s going on and explore recommended treatment options. With appropriate treatment, there’s always hope for improvements.

The post Behavior Changes After Stroke: Why They Happen & What It Means appeared first on Flint Rehab.

This article will discuss the causes of vomiting after stroke and highlight possible treatment options. Although there is not one ideal treatment for addressing vomiting after stroke, this article will describe some of the most common recommendations.

Understanding the Causes of Vomiting After Stroke

Some individuals may experience nausea and vomiting after stroke. While occasional vomiting after stroke may be concerning, persistent vomiting should be treated as a medical emergency. Since losing nutrients and fluids on a consistent basis can cause one’s health to rapidly decline, it is essential to seek medical attention in a timely manner.

It can be dangerous to self-diagnose and self-treat persistent vomiting because, if the wrong treatment is pursued, it can delay recovery and worsen malnutrition. Working with a skilled medical team is crucial.

Here are a few possible causes of vomiting after stroke:

• Cyclic vomiting syndrome. This condition is characterized by recurrent episodes of stereotyped vomiting separated by regular symptom-free periods. Researchers speculate that cyclic vomiting syndrome occurs as a result of dysfunction in the gut-brain connection.
• Side effects from medication. Certain medications can cause vomiting in some individuals. To investigate this, check the side effects on medication labels and observe the relationship between the timing of medication administration and the onset of vomiting. However, regardless of findings, it is important for survivors to talk with their doctor before making any major medication changes.
• Onset of another stroke. While most commonly seen with hemorrhagic stroke, one study found that 14.5% of all stroke survivors experienced vomiting at the onset of stroke. Therefore, it is essential to watch for other stroke warning signs when vomiting occurs, such as slurred speech or weakness in one arm or leg. Seek medical attention immediately if a stroke is suspected.
• Damage to certain areas of the brain after stroke. Nausea and vomiting are frequently seen in individuals with vertebrobasilar stroke. Additionally, cerebellar stroke survivors commonly experience severe vertigo, nausea, and vomiting, along with poor balance.
• Ictal vomiting. Although rare, sometimes seizures manifest as vomiting. Since there is an increased likelihood of seizures after stroke, it is a possibility that vomiting may signal seizure activity.
• Vestibular disorders. When the vestibular system is impacted by stroke, it can cause poor balance, impaired gait, dizziness, nausea, and vomiting.

With such a wide range of causes, it is vital to monitor vomiting frequency and the circumstances surrounding episodes to help accurately determine the cause. Identifying the cause of vomiting after stroke can influence recommended treatment options.

How Is Vomiting After Stroke Treated?

Often, hospitalization is required for persistent vomiting to replenish fluids and provide essential nutrients. During hospitalization, the medical team may perform a number of tests to diagnose any underlying conditions.

After diagnosis, treatment options for vomiting after stroke may include:

Prescribing Medications

Depending on the cause of vomiting after stroke, medication may help relieve symptoms. For example:

• Tricyclic antidepressants, such as imipramine hydrochloride, may improve cyclic vomiting syndrome, potentially due to their impact on the gut-brain axis.
• Anti-seizure medications may relieve ictal vomiting.
• Pharmacological treatments for vestibular dysfunction and vertigo may also relieve nausea and vomiting.

While medications are not always the answer, they may help. However, individuals should always talk with their doctor before adding any new medications.

Adjusting Problematic Medications

Although medications can help relieve vomiting, they can also be a contributing cause. If vomiting is listed as a potential side effect of any new prescriptions, begin watching for any patterns surrounding the timing of vomiting and medication administration. It is possible that nausea and/or vomiting occur after taking certain prescriptions.

If it seems probable that a new prescription is resulting in vomiting and nausea, individuals should discuss potential solutions with their doctor. It may be possible to substitute the problematic medication for a similar medicine that is more tolerable.

Vestibular Rehabilitation

When nausea and vomiting are accompanied by balance challenges, the vestibular system may be affected. In this case, vestibular rehabilitation may help.

Vestibular rehabilitation exercises are designed to help retrain the brain and body to regulate the sense of equilibrium. Ideally, this therapy may reduce feelings of nausea and/or vomiting among those experiencing vestibular dysfunction after stroke.

Alternative Remedies: Acupuncture and Herbal Supplements

While alternative remedies may help relieve vomiting after stroke, some doctors may recommend using caution with these types of treatments. This is because there is still insufficient evidence supporting their use.

Furthermore, relying on alternative remedies rather than using more medically effective treatments could prolong vomiting, exacerbating the negative side effects of long-term vomiting. Still, with a doctor’s approval, alternative remedies could be worth a shot, especially if used in conjunction with other treatments.

While not specific to stroke survivors, there is a growing body of evidence supporting the use of acupuncture to relieve vomiting. For example, systematic reviews have suggested that acupuncture may help reduce nausea and vomiting related to chemotherapy and pregnancy, as well as symptoms that occur post-operatively. This is especially true when acupuncture is combined with conventional treatments.

While there don’t seem to be any studies regarding the effectiveness of acupuncture for reducing vomiting among stroke survivors yet, acupuncture is a low-risk treatment. Especially since acupuncture can also have other stroke-related benefits, it could be worth a try.

Chinese herbs may also be used to reduce vomiting after stroke. While clinical studies seem to be lacking here as well, it could be worth looking into for those interested in an alternative approach. However, it is always recommended that survivors discuss all treatments they are pursuing with their doctor.

Overcoming Nausea and Vomiting After Stroke

With many potential causes for vomiting after stroke, it is critical to work with a doctor for a formal diagnosis. This can help expedite treatment and reduce negative side effects.

While more research is needed regarding effective treatments for vomiting after stroke, adding or adjusting medications may help relieve symptoms. Vestibular therapy may also be effective for those experiencing vomiting as a result of vertigo or other types of vestibular dysfunction. Alternative remedies may also be considered in conjunction with a doctor’s approval.

Hopefully the information in this article can serve as a starting point for learning about possible causes and remedies for vomiting after stroke. As always, it is strongly recommended that survivors consult with their doctor to determine which treatments may be most effective for their specific condition.

The post Vomiting After Stroke: Understanding Why It Happens & How to Treat It appeared first on Flint Rehab.

This article will discuss the causes and treatment for prosopagnosia after stroke.

Why Can’t I Recognize Faces After Stroke?

Prosopagnosia is a neurological disorder that, most notably, impairs an individual’s ability to recognize faces. It can sometimes impair a person’s ability to understand facial expressions as well. In some rare cases, people with the condition report difficulty recognizing other things like places or objects, however, this would typically be classified as a different type of agnosia altogether.

A common cause of prosopagnosia is stroke. A stroke occurs when the supply of blood to the brain is compromised. When this happens, areas of the brain that are deprived of oxygen-rich blood  are damaged, which leads to secondary effects — such as prosopagnosia.

The brain is organized such that each area of the brain controls specific functions. After a stroke, it helps to understand which area of the brain is affected by your stroke to roughly determine which secondary effects you may experience. One clinical sample found that half of those who survived a right hemisphere stroke had prosopagnosia.

Another study looked at 44 stroke survivors with prosopagnosia and found that the majority of them had damage in the right fusiform gyrus. This area of the brain, part of the temporal and occipital lobes, is thought to play a major role in facial recognition. However, not every individual with a stroke in the temporal or occipital lobes will experience prosopagnosia, because every brain is different and every stroke is different. Even among individuals who can’t recognize faces after stroke, differences in causes and symptoms of the condition exist.

Symptoms of Prosopagnosia After Stroke

In severe cases, a survivor with prosopagnosia can’t recognize familiar faces after stroke – even the faces of close friends and family. Other individuals may have trouble distinguishing between two unknown faces, or even between a face and an object. In rare cases, the struggle may be with recognizing certain facial cues.

It’s important to work with a neurologist to get an accurate diagnosis and understanding. Otherwise, the individual runs the risk of being deeply misunderstood. For example, a survivor may not realize that they can’t recognize facial cues. If someone looks sad, the person with prosopagnosia may not realize it and may say something insensitive.

In this example, the person with prosopagnosia could be deeply misunderstood as apathetic or self-centered. This is why it’s important to work with a neurologist for an accurate diagnosis and better understanding.

Treatment for Prosopagnosia

Treatment for most secondary effects of a stroke depend on neuroplasticity. Neuroplasticity is the brain’s natural ability to rewire itself. It’s the basis for both learning in the intact brain and relearning in the damaged brain that occurs during rehabilitation. Neuroplasticity allows healthy areas of the brain to take on the function of damaged ones.

Therefore, if facial recognition is impaired due to damage to the right fusiform gyrus (or another area that contributes to facial recognition), then neuroplasticity is the process by which the healthy areas learn to take on that function. But how?

Neuroplasticity is new growth that is activated by massed practice. When a skill is practiced with high intensity, the brain strengthens the neural pathways for that function.

It can be argued that practicing facial recognition can help a person with prosopagnosia get better at this task. Some cognitive training apps, such as the CT Speech & Cognitive Therapy app, contain activities that involve matching faces. Loved ones may also come up with other games to engage individuals with ways to practice facial recognition.

Alexander Cohen, MD, Ph.D. – who led a study on 44 stroke survivors with prosopagnosia – mentioned that “novel therapies like transcranial magnetic stimulation or functional-MRI-based neurofeedback” can be explored to possibly enhance neuroplasticity when combined with massed practice.

Using Compensation Strategies in the Meantime

Rehabilitation is a slow process, and before your brain can adapt you may want to implement some compensation strategies to cope with this condition.

For instance, some individuals are assisted in identifying a face by remembering the clothing a person is wearing. Others get more creative by using voice tone, body shape, type of hair, or gait to help identify people.

Ultimately, compensation strategies offer shortcuts that help survivors cope with their condition. This is a way to improve your quality of life as you pursue recovery.

Coping with Prosopagnosia After Stroke

If you or a loved one struggles with recognizing faces after a stroke, work with a neurologist for a formal diagnosis. Consider doing cognitive training activities that help you practice recognizing faces. The brain is highly adaptive and can learn with massed practice. You’ll never know what’s possible until you try. In the meantime, try to develop some compensation strategies that can help you identify close friends and family without needing to rely on faces.

We wish you the best of luck on your unique journey!

The post Can’t Recognize Faces After Stroke? You May Have Prosopagnosia appeared first on Flint Rehab.

In this article, we will discuss the causes, symptoms, and treatment for restless leg syndrome after stroke.

What is Restless Leg Syndrome?

Although there are a variety of sensations experienced with restless leg syndrome after stroke, the most common is the overwhelming desire to move your legs, as the name implies.

Restless leg syndrome (RLS), also known as Willis-Ekbom Disease, causes unpleasant sensations in the legs coupled with an urge to move them. This may result in sleepless nights which snowball into other secondary effects from stroke, like daytime sleepiness and chronic fatigue.

The cause of restless leg syndrome after stroke is unknown in most cases. Surprisingly, RLS impacts about 10% of Americans regardless of a stroke diagnosis, according to the National Institute of Neurological Disorders.

Though it can occur at any age, RLS is often experienced more severely in middle age or later. Additionally, women are twice more likely than men to have RLS.

The Basal Ganglia & Restless Leg Syndrome After Stroke

While the cause of restless leg syndrome is a mystery, many studies suggest that symptoms associated with RLS emerge within a few days following stroke. Newer research is examining the relationship between RLS and strokes involving the basal ganglia.

The basal ganglia is a cluster of neurons located deep in the cerebral cortex. It plays an essential role in helping the brain coordinate movement. It regulates a balance between the agonist muscles (muscles that initiate movement) and antagonist muscles (muscles that inhibit movement).

If a stroke damages part of the basal ganglia, its ability to keep this balance is disrupted and can cause abnormal muscle movements, resulting in twitching, stiffness, tremors, and other irregularities.

Other Causes of Restless Leg Syndrome After Stroke

Restless leg syndrome after stroke share similar risk factors such as smoking, high blood pressure, high cholesterol, diabetes, and obesity. Obesity can cause a disruption in the dopamine pathways in the brain, which can also contribute to RLS symptoms.

Other potential causes of RLS include:

• Sleep deprivation
• Genetic predisposition
• Environmental triggers
• Low levels of iron in the brain
• Medications taken to treat conditions such as allergies
• Nausea
• Depression
• Psychosis

Caffeine or alcohol consumption can also trigger or intensify symptoms. Restless leg syndrome can also result from other health conditions, like peripheral neuropathy, diabetes, or kidney failure. In these cases, treating the primary condition may resolve RLS symptoms.

Symptoms of Restless Leg Syndrome

Common symptoms of restless leg syndrome include:

• A desire to move legs especially when sitting still or lying in bed.
• Abnormal leg sensations (e.g., tingling, crawling, or pulling.)
• Worsened symptoms at rest and end of the day.

In the case of mild restless leg syndrome, these symptoms may not occur every night and can mistakenly be attributed to restlessness, anxiety, or stress.

More severe cases of RLS can make it difficult to enjoy and engage in the simplest activities such as sitting on a plane for a long period of time or sitting through a movie.

Treatment for Restless Leg Syndrome

There are several options available to help treat the symptoms of restless leg syndrome after stroke. The best way to treat RLS is to treat the symptoms, according to the National Institute of Neurological Disorders and Stroke.

Moving your legs, or walking around may provide some temporary relief. Also, in the case of an underlying medical condition, such as iron deficiency anemia or diabetes, appropriately treating the original condition can provide relief towards RLS.

Other treatment options include:

Lifestyle changes

• Reduce or eliminate intake of caffeine, alcohol, and tobacco.
• Strive for a regular sleep schedule.
• Get some exercise every day.
• Consider wearing compression during the day.
• Massage or stretch your leg muscles in the evening.
• Soak in a hot bath before bed.
• Use a heating pad or ice pack when experiencing symptoms.
• Arrange activities that require prolonged sitting earlier in the day rather than letter.
• Take a look at your diet to make sure you are getting enough essential vitamins and nutrients.
• Consider increasing foods with vitamin C to increase your iron absorption.

Supplements

• Iron supplements may be helpful if you have iron deficiency.
• Magnesium supplements or magnesium oil have been shown to help improve restless leg syndrome.

Before adding supplements to your diet, it’s important to consult your physician or nutritionist.

Medications

• Dopaminergic agents can help decrease motion in your legs.
• Narcotics such as opioids can decrease pain and strange sensations and help you relax.
• Sleep aids and muscle relaxants such as benzodiazepines can help you relax and sleep better.

Though there is no cure for restless leg syndrome, managing the symptoms will provide relief. For treatment options, it is best to consult your doctors to see what treatment and/or medications would be appropriate for you!

The post Restless Leg Syndrome After Stroke: Causes, Symptoms and Treatment appeared first on Flint Rehab.

This article describes why memory may be affected after stroke and provides an overview of a few techniques that may be recommended to improve memory. Use the links below to jump straight to any section:

• Why Memory Difficulties Occur After Stroke
• How to Improve Memory After Stroke
• Techniques to Overcome Memory Problems after a Stroke
• Can Memory Improve on Its Own After a Stroke?

Why Memory Difficulties Occur After Stroke

Memory involves three steps: creating the memory by encoding information, storing information for short or long periods of time, and recalling stored information when desired. There are a number of types of memory, including:

• Episodic memory: used for past or recent events and experiences
• Prospective memory: involves remembering future activities
• Semantic memory: used for concrete information, like facts and concepts
• Verbal memory: includes words, stories, or other verbally presented information
• Visual memory: used to recall pictures, faces, routes or other visual information
• Working memory: similar to a mental sticky note; provides temporary storage for a small amount of readily accessible information

Following a stroke, survivors may have difficulties with one or more of these types of memory, depending on which areas of the brain were affected. For example, a stroke in the hippocampus may affect the ability to form new memories, while episodic memories may be disrupted after a thalamic or medial temporal lobe stroke.

Fortunately, cognitive rehabilitation can improve memory after a stroke. Cognitive rehabilitation involves retraining cognitive functions such as memory and, when necessary, teaching compensation strategies to cope with impaired skills.

Both speech-language pathologists (SLPs) and occupational therapists can address memory problems after stroke. Because memory difficulties and language impairments often overlap, SLPs can be great resources for survivors struggling with cognitive tasks. When cognitive challenges affect day-to-day activities, occupational therapists can collaborate with the survivor to adapt or modify activities and recommend compensatory strategies.

How to Improve Memory After Stroke

The brain has an incredible ability to heal after injury and rewire itself. This process, known as neuroplasticity, allows the brain to adapt to experience to gain or regain functions after a neurological injury like a stroke.

Neuroplasticity is activated through massed practice, which involves consistently and repetitively performing specific tasks involving targeted skills. Over time, the brain adapts to activities practiced on a regular basis by strengthening associated neural pathways.

Therefore, in order to promote the recovery of memory skills through neuroplasticity, individuals are often recommended to consistently and repetitively practice memory-specific tasks and exercises. Consulting a speech-language pathologist and/or occupational therapist can be very beneficial, as these professionals can create personalized exercise programs and help determine whether other cognitive skills have been affected.

Techniques to Overcome Memory Problems

There are two methods for overcoming memory deficits among stroke patients: rehabilitative exercise and compensation strategies. Rehabilitative exercise focuses on regaining memory functions by practicing cognitive exercises to encourage neuroplasticity. On the other hand, compensation strategies offer “shortcuts” around memory impairments by using specific techniques to improve functional performance despite memory deficits.

Rehabilitative Exercises to Improve Memory after Stroke

Repetitively practicing rehabilitative exercises can be an excellent way to improve memory. Rather than using rote exercises, practicing memory activities is often encouraged, as many activities focus on the same skill sets and tend to be more engaging.

While working with a speech language pathologist to develop a customized treatment plan is recommended, here a few commonly used activities that may help improve memory after stroke:

• Games. Card games involving matching, such as Concentration or Go Fish, can help enhance working memory skills. More advanced games, such as Simon (involves repeating visual sequences) or Guess Who? (involves categorizing pictures by similarities and differences) can provide an added memory challenge.
• Paper and pencil activities. Many paper and pencil tasks, such as word searches, spot the difference pictures or Sudoku, can also enhance memory skills. These are often available in beginner, intermediate and advanced levels, allowing them to be easily modified to fit the survivor’s abilities.
• Technology-based exercises. There are a growing number of technology-based programs designed to improve cognitive skills such as memory. For example, the CT Speech & Cognitive Therapy App has over 100,000 exercises focused on improving cognition and language. It can also automatically adjust exercises to fit the survivor’s ability level. Other programs, such as Lumosity or virtual reality, may also boost memory skills.

When combined with memory exercises, regular physical activity and non-invasive brain stimulation may also boost neuroplasticity and promote recovery. Survivors should consult their doctor and rehabilitation team for more individualized recommendations.

Compensation Strategies for Memory Problems after Stroke

While recovering memory functions is ideal, it can be very helpful to learn how to compensate for memory problems. When memory challenges interfere with daily activities, occupational therapists can help survivors find effective techniques to promote functional independence despite memory deficits.

Here are some helpful compensation strategies that may be recommended:

• Reminder apps. Using a reminder app or preset alarm on one’s smartphone can help survivors stay on top of important activities, such as feeding a pet or going to therapy appointments. Individuals should try to keep their phone with them or set in the same place — ideally a central location that can be heard from most rooms.
• Routine. Setting a consistent routine for essential daily activities, such as taking prescribed medication, can also help with memory difficulties. When possible, try pairing activities together, such as always taking medications while eating breakfast.
• Simplification. Simplifying common activities, such as cooking, may also help compensate for memory deficits. For example, rather than making meals with longs lists of ingredients and steps, consider making less complicated foods or using precut fruits and vegetables.
• Lists. Finally, it can be helpful to use lists to ensure tasks are completed properly. Keeping a grocery list or a list of regular cleaning tasks that need to be completed each week can help individuals maintain their independence despite memory challenges.

Using a combination of rehabilitative exercises and compensation strategies can allow survivors to function optimally as they pursue recovery. Working with family members and the rehabilitative team can help survivors find the most beneficial strategies to promote both recovery and independence.

Can Memory Improve without Rehabilitation?

While not always the case, it is possible for stroke-related memory deficits to improve on their own. This phenomenon, known as spontaneous recovery, usually occurs during the acute (early) stages of recovery.

There are a few possible reasons for this: 1) brain swelling is reducing during this time; 2) neuroplasticity is often heightened during the acute stage; and 3) the intensity of rehabilitation is usually highest while individuals participate in inpatient rehabilitation, which involves several hours of therapy per day during first few weeks to months after the stroke occurred.

While the idea of spontaneous recovery can provide hope, it should not be relied upon. Instead, a proactive approach is often best. By practicing cognitive rehabilitation exercises on a daily basis, individuals can encourage the brain to continue recovering well beyond the acute stages of recovery.

Improving Memory After Stroke

Impaired memory is a common cognitive effect of stroke that may be improved through rehabilitation. Speech-language pathologists and occupational therapists are experts on this issue. Together, they can create a rehabilitation plan tailored to the survivor’s strengths and needs.

The best way to improve memory after stroke is to practice memory-intensive cognitive rehabilitation exercises. However, if memory challenges persist, it may be beneficial to use compensation strategies to promote independence despite memory problems. While spontaneous recovery may occur and provide a boost in memory functions, pursuing rehabilitation is usually the best way to optimize outcomes.

The post How to Improve Memory After Stroke with Cognitive Rehabilitation appeared first on Flint Rehab.

This article includes the most effective writing exercises for stroke patients with peripheral or central agraphia.

Writing Exercises for Stroke Patients with Peripheral Agraphia (Hand Weakness)

Patients with peripheral agraphia know what they want to write, but they struggle with the fine motor control to manage writing physically due to weak grip strength or tremors. Writing exercises for stroke patients focus on improving hand function and handwriting.

Below are some writing exercises for stroke patients that improve strength and dexterity in the hand:

1. Practicing Grasp and Release Exercises

Regaining the ability to grasp and hold a pencil is the foundation to writing again after a stroke. By practicing grasp and release activities, you can improve your ability to hold a pencil.

The key is to practice a high number of repetitions of each exercise to help rewire the brain. Especially after a stroke, high repetition is key to regaining motor control.

But you also may notice some muscle fatigue. The smallermuscles fatigue more easily. Don’t let fatigue keep you from getting in many repetitions.

After some rest begin again training those fine muscles/nerves. Sometimes, the further away (more peripheral) from the core of your body, the slower the recovery. For example, hand function often takes longer to improve than arm function.

Therefore, take frequent, short breaks during writing exercises to prevent frustration or maladaptive compensation to complete the movement. Remember your body has to relearn these motor skills and that will take many repetitions over some time. 

Discover grasp and release exercises that can improve your grip »

2. Using a Universal Cuff

If you’re experiencing difficulties holding a pen or pencil after a stroke, using a universal cuff may assist with maintaining a functional grip on the pen. These aids keep you engaged and attempting movements which stimulate your brain to reform connections.

By sliding your writing utensil inside the slits of the universal cuff, you create a handle that helps ensure your writing utensil will not drop, even if you lose your grip on it.

There are additional adaptive devices that can assist with writing. An occupational therapist can help you decide which item is best suited for successful writing skills. They are also best suited to provide you with specific exercises or even stretches to address your unique weakness since people vary in their limitations after a stroke.

3. Pressing Piano Keys

Pressing on piano keys is a great way to develop finger strength, dexterity, and hand-eye coordination. Whether this is a familiar activity or not it is very stimulating for your nervous system due to the auditory inputs. When you perform an activity that is familiar, the brain usually has more cells/resources toactivate the muscle movement again.

These fine motor skills are essential for improving handwriting after a stroke. Playing the piano is a fun and engaging activity that makes it easy to perform the repetitions necessary to promote neuroplasticity.

4. Tracing

Following a visual cue is helpful for your brain as it is finding a new way to direct your muscles. Have someone write a few words on a piece of paper so that you can use it as a reference to trace over.

Ask them to write large and use a thick marker so that the words will be easier to trace. You can also create your own template on your computer, adjust the font size and thickness, and print it to create your reference sheet to trace.

Having a reference sheet will encourage you to compare and fix your mistakes for more accurate handwriting.

5. Using Grasp and Release Rehab Technology

Technology helps us engage with exercises for stroke patients with less monotony and boredom.  Thankfully there’s a well established gripping device that will get you to engage with writing exercises for stroke patients while having a good time too.

This rehab tool focuses specifically on grasp and release activities and is called MusicGlove from Flint Rehab. MusicGlove combines music, gaming, and hand therapy for an engaging rehabilitation experience that is clinically proven to improve hand function in 2 weeks.

By following the keys on the screen and pinching your fingertips together, you practice curling your fingers in the same way you would to grip a pen.

6. Connect the Dots

Have someone write letters in dots, or find a worksheet like this one online and print it. Visualize the letters and connect the dots. This activity will guide your writing and familiarize your brain with the appropriate movements.

7. Finger Resistance Training

Place your fingers inside a rubber band and separate your fingers. The resistance of the rubber band will help strengthen your finger muscles. To increase resistance, add more rubber bands.

Writing Exercises for Stroke Patients with Central Agraphia (Language Processing Difficulties)

With central agraphia, cognition is affected. Even though you may be physically able to write, you may experience difficulties remembering how to spell or write down the correct letters.

Central agraphia is generally treated by working with a speech-language pathologist. These therapists are highly trained in helping stroke patients relearn how to write words after a stroke.

Try these writing exercises if you have central agraphia:

8. Copy and Recall Treatment (CART)

Copy and recall treatment involves repeatedly copying and re-writing to ensure that the individual can spell the targeted words. The more the patient writes the word, the more successfully its spelling is retained.

one technique a speech-language pathologist may emply involves writing a word down and while say it aloud. Then, the patient will be asked to copy the word down multiple times.

If the patient is successful, the speech-language pathologist will take away or cover all examples of the written word and ask the patient to write it down from memory multiple times.

Many repetitions are involved to engage the brain again. Asking your doctor to prescribe treatments from a speech-language pathologist will put you on a good path towards practicing at home until your brain begins to adapt.

9. Anagram and Copy Treatment (ACT)

Anagram and copy treatment involves training the patient to recognize the letters that make up a word and arranging them in the proper order. A speech-language pathologist will display the letters that make up a word in scrambled order and then ask the patient to spell the target word using the letters available.

If correct, the patient will be asked to write it down multiple times. If incorrect, the speech-language pathologist will write it down for the patient, and then have the patient copy the correct spellin multiple times. The letters will be re-scrambled until the patient can independently write the word correctly

Getting Back to Writing After Stroke

If you struggle with agraphia after a stroke, make sure you get an accurate diagnosis from your Speech-Language Pathologist. There are a variety of ways your stroke may have impaired this complex skill. A correct diagnosis will help you practice the most relevant exercises to improve writing after a stroke.

It’s important to promote neuroplasticity by performing high repetition of each exercise. More repetition means more stimulation for the brain, which helps the brain rewire itself and regain control of the hand.

We hope these exercises help you get back to writing after your stroke!

The post Writing Exercises For Stroke Patients to Improve Agraphia appeared first on Flint Rehab.

This article will highlight the 4 most common causes of muscle twitching and some effective recovery methods.

4 Causes of Muscle Twitching After Stroke

Before we get started, it’s important to know that you should consult your doctor or therapist if your symptoms are accompanied by pain, discomfort, or reduced quality of life. Your doctor can help diagnose your condition and a therapist will guide your rehabilitation.

Here are some common causes of muscle twitching after stroke:

1. Spasticity

If muscle twitches are accompanied by stiffness and difficulty with movement, then it’s likely a symptom of spasticity. In this case, it’s critical to work with your doctor or therapist. Your doctor may prescribe Botox injections to help temporarily relieve spasticity, while your therapist can prescribe stretches and exercises, which help reduce spasticity long-term.

2. Tremors

When muscles twitch in a constant, rhythmic fashion, it could be a sign of tremors. Tremors often have delayed onset after a stroke, which means they can manifest months later. If you think you’ve developed tremors after stroke, talk to your doctor.

3. Involuntary movement disorders

Aside from tremors, there are other involuntary movement disorders that can cause muscle twitches. For instance, some stroke patients may develop muscle twitching from conditions like clonus, chorea, athetosis, or dystonia.

4. The affected muscles are “waking up”

Some stroke patients experience twitching in their affected muscles right before they regain movement, especially in patients with hemiplegia (paralysis of half the body).

If you have been regularly participating in rehabilitation, then muscle twitching could be a sign of recovery. However, it’s impossible to tell, so a conversation with your doctor or therapist is always the safest route.

Treating Muscle Twitching After Stroke

Muscle twitching after stroke can be a sign of progress or problems, depending on the context. Fortunately, treatment is roughly similar no matter what the issue.

We recommend consulting with a physical rehabilitation specialist like a Physical Therapist or an Occupational Therapist to help improve muscle twitching after stroke. They can prescribe exercises or specific stretches to improve blood flow to the affected muscles and even rewire the brain to improve control over your muscles.

If the twitching is caused by spasticity, rehab exercises are well-known to help. Furthermore, if the twitching is a sign of your muscles “waking up,” then rehab exercises will help you maximize your neurological control of those muscles.

However, if muscle twitches are painful or limiting your mobility, talk to your doctor about Botox or medication. This can help relieve the symptoms (like spasticity and muscle tightness) and temporarily improve mobility.

Then, use this increase in mobility to  become more active, and provide more stimulus to your brain and muscles. That way, you’re addressing the root problem too.

Wrap Up: What We Know About Muscle Twitches

Overall, muscle twitching after stroke is thought to be a sign of spasticity, but it could indicate other issues.

In some cases, it’s a sign of recovery; and focusing on physical rehabilitation exercises can help you make a good situation even better.

If your twitches are caused by the worsening of a condition, physical therapy can still help. In this case, it’s best to work alongside a trained therapist who can provide a proper diagnosis and treatment plan.

It’s always a good idea to consult with your medical team, especially when new symptoms appear. Best of luck on the road to recovery.

The post Muscle Twitching After Stroke: It Could Be More than Spasticity appeared first on Flint Rehab.