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.

If you or someone you know is navigating the complexities of homonymous hemianopsia, you’re not alone. In this comprehensive guide, we will take a look at what homonymous hemianopsia is and why it happens. We will also explore the different features of left and right homonymous hemianopsia as well as incomplete hemianopsia. 

Our goal is to help you better understand the condition and break down intricacies in a friendly and easy to understand manner – let’s jump in!

What Exactly is Homonymous Hemianopsia?

Let’s break down the term itself. “Homonymous” means “on the same side,” and “hemianopsia” refers to a loss of vision in half of the visual field. So, homonymous hemianopsia is the loss of vision in the same half of the visual field in both eyes. This is in contrast to bitemporal hemianopsia (also called heteronymous hemianopia), where vision loss occurs on the temporal (outer) side of both eyes.

Think of your visual field as a complete circle surrounding you. Normally, both your eyes work together to capture this entire circle. In order for the brain to integrate information from both eyes and both sides of the visual field, approximately half of the nerve fibers from each eye (the middle portions) cross to the opposite side of the brain, while the other half continue toward the same side of the brain. This crossover occurs at the optic chiasm. 

Therefore, information from the right side of what you see goes to the left side of your brain, and information from the left side goes to the right side of your brain. This intricate cross-wiring is what allows us to have a full and integrated visual experience.

However, in individuals with homonymous hemianopsia, this pathway is disrupted, typically due to damage in the brain after the optic chiasm. This means that all of the information from one side of the visual field from both eyes has been lost.

If the visual pathway is disrupted before the optic chiasm, vision loss occurs only in the eye on the side of the damaged nerve, referred to as monocular vision loss. However, damage occurring at the optic chiasm can result in bitemporal hemianopsia, in which the outer portion of the visual field from both eyes is lost.

What Causes Homonymous Hemianopsia? The Common Culprits

Homonymous hemianopsia isn’t a condition that develops on its own. It’s usually a consequence of another neurological event that affects the visual pathways in the brain. 

HH frequently arises from vascular injury. In adults, cerebral infarcts (strokes) and intracranial hemorrhages are the most common culprits, accounting for a significant majority of cases. In fact, it is estimated that 52-70% of cases of hemianopsia result from stroke, with 8-10% of all stroke survivors experiencing homonymous hemianopsia permanently.

Other contributing factors include:

• Traumatic Brain Injury (TBI): accounts for 14% of homonymous hemianopsia cases
• Tumors: Particularly prevalent in pediatric cases, responsible for 11% of HH cases
• Iatrogenic Events: Injury resulting from medical treatment, such as neurosurgical procedures or radiation necrosis.
• Demyelinating Disorders: Such as multiple sclerosis (MS).
• Neurologic Diseases: Including Alzheimer’s disease and Creutzfeldt-Jakob disease.
• Vascular Malformations: Like arteriovenous malformations.
• Infections: Such as brain abscesses or toxoplasmosis.
• Inflammatory Diseases: Beyond MS, like neuromyelitis optica.
• Metabolic Diseases: Such as MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes).
• Seizures or Epilepsy: occipital, temporal or parietal lobe seizures may result in temporary homonymous hemianopsia
• Migraines: can cause temporary homonymous hemianopsia
• Transient Ischemic Attacks (TIAs): may also cause temporary HH with spontaneous recovery
• Nonketotic Hyperglycemia: can resolve with proper blood sugar management

The specific location of the brain lesion dictates the type and extent of the HH. Studies have shown that the most common lesion locations are the occipital lobe, followed by the optic radiation, optic tract, and less frequently, the lateral geniculate nucleus (LGN).

The location and extent of the brain injury will determine which side of the visual field is affected and the severity of the vision loss.

Understanding the Impact: Common Symptoms and Features of Homonymous Hemianopsia

Individuals with homonymous hemianopsia experience a loss of vision in either the right or left  half of their visual field in both eyes. This can manifest in various ways:

• Complete Hemianopsia: Loss of the entire half of the visual field on the affected side, including the central macular vision.
• Partial or Incomplete Hemianopsia: Vision loss that doesn’t encompass the entire half of the visual field. This includes:
  • Homonymous Quadrantanopia: Loss of one-quarter of the visual field (either upper or lower, on the same side in both eyes). Damage to the upper or lower banks of the visual cortex or specific parts of the optic radiation can cause this.
  • HH with Macular Sparing: Retention of central vision despite the hemianopic defect. This is often seen in occipital lobe strokes due to the dual blood supply to the macular region.
  • Homonymous Scotomatous Defects: Rare, localized blind spots within the central 30 degrees of vision, respecting the vertical midline; this is somewhat of a reversal of HH with macular sparing.
  • Homonymous Sectoranopia: A rare, wedge-shaped loss of vision, often linked to LGN involvement.
  • Temporal Crescent Sparing: Loss of the outermost peripheral vision on one side only, resulting from anterior occipital lobe damage on the side of the brain opposite from the eye with vision loss.

Patients with HH may initially report difficulties such as bumping into objects on their blind side, struggling with reading (especially tracking lines of text), and challenges with navigation and driving.

Understanding Left, Right Homonymous Hemianopsia and the Concept of Contralateral 

Now, let’s take a look at some of the specifics in how homonymous hemianopsia can manifest. Specifically, we will look at left and right homonymous hemianopsia and the concept of contralateral hemianopsia.

1. Right Homonymous Hemianopsia

Imagine looking straight ahead. If you have right homonymous hemianopsia, you will have lost vision in the right half of your visual field in both eyes. This means you can see things to your left, but everything on your right side will be out of view.

Think about everyday scenarios:

• Walking
• Reading
• Driving
• Eating

With right homonymous hemianopsia, each of these everyday scenarios become significantly more difficult.  Reading can be particularly challenging with right HH when trying to read from the left to the right, as it is continually challenging to see the next word.

Right homonymous hemianopsia is typically caused by damage to the left side of the brain, specifically the occipital lobe or the visual pathways leading to it. Remember the cross-wiring described above – the left side of the brain processes information from the right visual field.

2. Left Homonymous Hemianopsia

Conversely, left homonymous hemianopsia involves the loss of vision in the left half of the visual field in both eyes. In other words, you’ll be able to see things on your right, but everything to your left will be invisible.

Left homonymous hemianopsia is usually caused by damage to the right side of the brain, affecting the occipital lobe or the visual pathways leading there. The right side of the brain processes information from the left visual field.

3. Contralateral: The Key Concept

The terms “left” and “right” homonymous hemianopsia inherently involve the concept of contralateral. “Contra” means “opposite,” and “lateral” refers to “side.” In the context of the visual pathways, the brain processes visual information from the opposite side of the visual field.

Therefore:

• Damage to the left side of the brain results in a visual field defect on the right side (right homonymous hemianopsia).
• Damage to the right side of the brain results in a visual field defect on the left side (left homonymous hemianopsia).

Understanding this contralateral relationship is crucial for patients and healthcare professionals to understand the location of the brain injury that caused the vision loss.

Living with Homonymous Hemianopsia: How To Adapt to Challenges in Daily Life

Living with homonymous hemianopsia presents a unique set of challenges that can significantly impact daily life. The loss of half of the visual field can affect:

• Mobility and Navigation
• Reading and Writing
• Grooming and Self Care
• Driving
• Social Interactions
• Work and Hobbies

However, it’s important to emphasize that individuals with homonymous hemianopsia can learn to adapt and lead fulfilling lives. Let’s take a look at several rehabilitation strategies and assistive devices that play a crucial role in this process.

Navigating the Challenges: Rehabilitation and Compensation Strategies for Homonymous Hemianopsia

While lost vision in HH often cannot be restored, various strategies can help individuals adapt and improve their daily functioning.

These include:

• Prisms: Special lenses that can shift the visual field towards the blind side, increasing awareness of objects in that area. Peli prisms, placed in the upper and lower parts of the spectacle lens on the side of the HH, are a common type.
• Visual Scanning Training: Therapy focused on teaching conscious and systematic eye and head movements to compensate for the lost visual field, improving detection of objects on the affected side.
• Exploration Therapies: Techniques aimed at enhancing awareness of the visual field loss and improving visual search strategies.
• Occupational Therapy: Helps individuals adapt to daily activities such as dressing, eating, and navigating their environment.
• Orientation and Mobility Training: Specialists teach safe and effective techniques for moving around indoors and outdoors.
• Assistive Technology: Computer software, screen readers, and navigation apps can aid with reading, writing, and mobility.
• Psychological Support: Addressing the emotional impact of vision loss and providing coping strategies is crucial.

Can You Improve Homonymous Hemianopsia?

Spontaneous improvement of HH can occur, particularly in the initial months after the injury, especially following a stroke. Studies suggest that 50-60% of individuals may experience some visual field recovery within the first month, with most improvement occurring within three to six months. Complete spontaneous recovery is less common, but may occur in 8-12% of those with homonymous hemianopsia.

Spontaneous recovery after six months is less common. At that point, improvements may also be linked to the resolution of underlying medical conditions.

Potential Complications of Homonymous Hemianopsia

Beyond the visual field deficit itself, individuals with HH may experience:

• Increased Risk of Falls and Injuries: Due to reduced awareness of their surroundings.
• Difficulties with Mobility and Navigation: Making everyday tasks like walking and crossing the street challenging.
• Reading and Writing Difficulties: Affecting communication and daily tasks.
• Driving Limitations: Often making driving unsafe and legally restricted in many areas.
• Psychological Impact: Including feelings of disorientation, anxiety, and depression.

Living Fully with Half the World

While the diagnosis of homonymous hemianopsia can be life-altering, it doesn’t define a person’s potential. With dedicated rehabilitation, adaptive strategies, and a strong support system, individuals can learn to navigate their world effectively and participate fully in life. By understanding the nuances of left and right homonymous hemianopsia, as well as incomplete hemianopsia, we can better support those living with this condition and empower them to see their world in new and meaningful ways.

If you or someone you know is experiencing vision loss, it’s crucial to seek professional medical advice promptly. Early diagnosis and intervention are key to maximizing adaptation and improving quality of life. Remember, even with half the visual field, a whole and fulfilling life is still within reach.

The post Seeing Half the World: Understanding Left and Right Homonymous Hemianopsia Plus Strategies Adapt and Improve appeared first on Flint Rehab.

This article will discuss the causes of TBI involuntary movements, the different types, and how to find the best treatment.

Use the links below to jump straight to any section:

• How a TBI Causes Involuntary Movements
• Types of Involuntary Movement Disorders
• Delayed Onset of TBI Symptoms
• Restoring Movement with Neuroplasticity
• Treatment for Involuntary Movement Disorders

Causes of Traumatic Brain Injury Involuntary Movements

A traumatic brain injury can disrupt communication between the brain and the body. Without proper communication, the muscles are unable to receive signals from the brain, and the brain may not receive feedback from the muscles. This can result in impaired motor control. Studies have shown that involuntary movement disorders have been reported in about 22.6% of survivors with a severe head injury, with 12.2% of individuals reporting persistent symptoms.

Of note, persistent post traumatic movement disorders are rarely experienced by survivors with a mild or moderate traumatic brain injury, and only 5.4% of severe brain injury survivors report significant disability due to involuntary movement disorders.

The type of involuntary movement disorder that develops depends on which area of the brain is injured. For example, common causes of post traumatic movement disorders include:

• Primary motor cortex damage: can cause muscle weakness or paralysis
• Cerebellum damage: can cause tremors and/or loss of balance and coordination
• Basal ganglia damage: can cause uncontrollable twitching, spasms, or dystonia
• Thalamus damage: can cause apraxia (difficulties with motor planning) or other motor impairments

Since post traumatic movement disorders may have an immediate or delayed onset, studies report a wide range of prevalence, with anywhere between 13-66% of TBI survivors experiencing movement disorders.

Fortunately, many involuntary movements caused by TBI damage can be managed through rehabilitative techniques.

Types of Involuntary Movement Disorders After TBI

Understanding the various types of traumatic brain injury involuntary movements that can occur is important in order to receive the appropriate treatment and promote recovery.

Some of the most common types of movement disorders after TBI include:

1. Tremors

What it looks like: unprovoked, uncontrollable, rhythmic shaking

Tremors are one the most common types of involuntary movements that occur after a brain injury. Studies show that about 9% of severe TBI survivors experience persistent tremors, while nearly half of all children with traumatic brain injuries experience tremors, lasting up to 18 months. These tremors are characterized by an uncontrollable, rhythmic shaking of different parts of the body, typically the hands.

Tremors are further classified into different categories, including:

• Resting tremors: occur when the muscles are relaxed, such as when the hands are resting in an individual’s lap.
• Action tremors: occur when the muscles are in use. There are many types of action tremors, including postural tremors (occur when an individual holds a position against gravity) and intention tremors (occur when completing a purposeful movement).

The most frequent types of tremors that develop after a head injury are cerebellar tremors, which as the name implies, are caused by damage to the cerebellum. They are a type of action tremor that only occurs at the end of a movement.

2. Dystonia

What it looks like: slow, repetitive twisting movements

Dystonia is another common involuntary movement disorder that occurs from damage to the basal ganglia. Dystonia refers to slow, repetitive twisting movements. These involuntary muscle contractions often force people into abnormal positions. About 4% of severe TBI survivors experience dystonia after brain injury.

This can include different types of dystonia such as:

• Focal dystonia: affects only part of the body such as the eyes, jaw, mouth, neck, arms, or legs. A more specific type of focal dystonia is known as cervical dystonia, which causes spasms in the neck.
• Segmental dystonia: affects two or more adjacent muscle groups simultaneously. For example, survivors may experience spasms in the jaw and neck at the same time.
• General dystonia: affects the whole body.

Generally speaking, movements resulting from dystonia occur on the opposite side of your body from where the injury occurred. For instance, if you experience a left-hemisphere brain injury, it is likely you will experience dystonia on the right side of the body. Though less common, dystonia may also cause the torso to bend or writhe.

3. Chorea

What it looks like: provoked, uncontrollable, rhythmic, dance-like movements

The word chorea comes from a Greek term meaning “to dance”. This is due to characteristic brief, repetitive movements of chorea, which tend to start in one body part and move abruptly to another part. Chorea is caused by damage to the basal ganglia.

Hemiballismus is a severe secondary type of chorea, which involves an aggressive, involuntary flinging of the arm and/or leg on one side of the body.  Those with hemiballismus usually exhibit wider and more vigorous movements than those with primary chorea due to extended damage in the thalamus. Chorea can often occur simultaneously with another movement disorder known as athetosis.

4. Athetosis

What it looks like: slow, flowing, writhing movements

Athetosis refers to a stream of slow, flowing, writhing movements. This involuntary movement disorder primarily occurs in the hands, feet, and torso. Both chorea and athetosis are caused by overactivity in the basal ganglia, usually due to excess dopamine in the brain.

5. Clonus

What it looks like: rhythmic shaking after a muscle is stretched

Clonus refers to a hyperactive stretch reflex that is often mistaken for a tremor because the symptoms are similar. Both conditions can cause rhythmic shaking that is painless, and mainly occur in the arms or legs. However, a distinct feature of clonus is that it is triggered and/or exacerbated by stretching the affected limb.

Similar to other movement disorders however, clonus often occurs when the electrical signals sent by the brain to the muscles are disrupted. Without proper stimulation from the brain, the muscles do not know whether to contract or relax. This uncertainty causes the muscles to do both.

6. Myoclonus

What it looks like: unprovoked, unrhythmic muscle spasms 

Though myoclonus sounds similar to clonus, it is a distinct disorder that does not cause rhythmic shaking nor does it change in response to stretching. Myoclonus refers to sudden muscle spasms that can happen at rest or during active movement. 

Many individuals experience myoclonus throughout their life such as when they hiccup or jerk awake just before falling asleep. However, myoclonus after a head injury tends to be more severe and frequent. While it may affect the limbs, it may also affect the palate or the oculomotor (eye movement) muscles.

7. Parkinsonism

What it looks like: a combination of involuntary movement disorders

Parkinsonism is an umbrella term that refers to a group of movement disorders that share similar symptoms. It typically occurs after repeated head trauma. 

Symptoms of Parkinsonism can include: 

• Resting tremor
• Stiff muscles
• Slow movements
• Shuffling gait
• Difficulty with balance and/or walking

Parkinson’s Disease is the most common type of parkinsonism that occurs. However, there are several other types including drug-induced parkinsonism, vascular parkinsonism, and post-traumatic parkinsonism (caused by damage to the cerebellum or basal ganglia). Approximately 3.1% of individuals with TBI experience post-traumatic parkinsonism, and that percentage increases to 11.6% in those with TBI after age 65. Post-traumatic parkinsonism often has a delayed onset, with an average estimated onset of 3.3 years after TBI.

 Parkinsonism can also cause uncontrolled, repetitive movements known as tics (see below).

8. Tics

What it looks like: sudden, repetitive movements or vocalizations

Tics are primarily involuntary movements that occur from damage to the basal ganglia, poor communication between different brain structures, or excess dopamine in the brain. Tics can cause individuals to make sudden, repetitive movements. Though most tics develop within the first few weeks after a brain injury, some may appear up to one year post-injury.

9. Gait Apraxia

What it looks like: uncoordinated movements while walking

Apraxia is a condition that causes difficulty with planning, coordinating and executing voluntary movements. There are different types of apraxia that can manifest, depending on the areas of the brain affected. For instance, damage to the cerebellum or frontal lobe can result in gait apraxia, which refers to the loss of ability to properly use the lower limbs. This can cause difficulty walking and/or maintaining balance.

10. Other Movement-Related Disorders

In addition to causing involuntary movements, a brain injury can also cause a variety of coordination disorders. These are typically caused by damage to the cerebellum, and can affect the ability to precisely perform voluntary movements. Many of these disorders can make it difficult to control the arms, legs, or trunk.

Movement-related disorders that may occur after a brain injury can include:

• Ataxia: is a coordination disorder that can make it difficult to perform everyday movements such as reaching for an object or walking. It often involves damage to the cerebellum, and may occur even following mild TBI. Individuals with ataxia of the legs are more prone to falls and may take wide, staggering steps when walking.
• Dysmetria: is when an individual cannot judge how far and how quickly their arms need to move to carry out a smooth purposeful movement. For instance, when reaching for an object, they will usually miss the mark.
• Apraxia of Speech: is a condition in which individuals cannot coordinate the muscles used for speech. As a result, they may make irregular mouth movements and have trouble speaking.
• Nystagmus: is a condition that makes it difficult to coordinate eye movements. This can cause the eyes to seem like they are bouncing around.

These types of movement and coordination disorders can often prevent individuals from controlling their arms, legs, or trunk. They may even inhibit them from using the muscles of their mouth or eyes accurately. Therefore, obtaining proper treatment is essential in order to improve muscle coordination after head injury.

Consult with your doctor or therapist if you notice any new or recurrent symptoms from any of the involuntary movement disorders listed above. With a proper diagnosis, treatment can be administered and rehabilitation started.

Delayed Onset of Involuntary Movements After TBI

Many involuntary movement disorders are not apparent right after the injury. Some individuals may experience a delayed onset of TBI symptoms or secondary effects. One study roughly estimated 57% of individuals reported new symptoms within one year of initial injury. This included a combination of different symptoms including physical, emotional, and cognitive effects.

Therefore, it’s important to keep track of any new recurrent symptoms and seek proper medical care. This can help lower the chances of TBI symptoms worsening over time or experiencing a decline during your recovery.

Speak to your doctor if you have any questions or concerns about your symptoms.

How Neuroplasticity Can Help Improve Traumatic Brain Injury Involuntary Movements

To treat TBI involuntary movements, the communication between the brain and the rest of the body must be restored. This can be accomplished with the help of neuroplasticity, the brain’s ability to heal and rewire itself. 

After a brain injury, many of the neural pathways used for communication between the brain and body may become damaged or destroyed. However, neuroplasticity can help strengthen existing neural pathways and create new ones, allowing the brain to adapt and recover from injury.

The best way to stimulate the brain and activate neuroplasticity is through repetitive exercise, also known as massed practice. Stimulating the brain after a head injury can help reduce the symptoms of post-traumatic involuntary movement disorders.

Practicing a movement consistently will help the brain create new neural pathways for those specific movements. With time, pathways associated with targeted movements may be rewired and reinforced in healthy, undamaged regions of the brain.

The stronger neural pathways, the better communication between the brain and body. And with better communication, the higher the chances of restoring motor control.

Treatment for Traumatic Brain Injury Involuntary Movements

Every brain injury is different, and treatment for involuntary movements may vary depending on the type and severity of the disorder. If your post-traumatic movement disorder is severe or causing you pain, doctors may prescribe medication such as baclofen. This helps relax the muscles and prevent spasms. 

However, medication is often only a temporary solution because it does not address the root cause of a post-traumatic movement disorder, which is the lack of communication between the brain and muscles. 

As previously mentioned, to improve the neural connections needed to regain functions, neuroplasticity must be activated through massed practice. Therefore, it is crucial to attend physical, speech, and/or occupational therapy sessions and practice rehabilitation exercises to promote recovery.

Each of these therapies utilize unique techniques and yield unique benefits for improving motor control, including:

• Physical Therapy: focuses on improving mobility, coordination, and strength. Physical therapists may use personalized stretches, hands-on techniques, repetitive exercises, and modalities to improve affected movements.
• Speech Therapy: assesses and treats oral motor concerns including dysphagia (difficulty swallowing) and speech difficulties through practicing specialized exercises.
• Occupational Therapy: addresses difficulty participating in daily tasks due to involuntary movements. To improve independence, occupational therapists may use activity-based exercises and/or introduce compensatory techniques and adaptive equipment.
• Home Exercise Programs: rehabilitative therapists usually recommend participating in a home exercise program to maximize the chances of recovery. They may provide a written exercise program or suggest usinghome therapy devices such as FitMi, aninteractive therapy device  designed to improve full-body mobility.

Depending on what types of involuntary movements you are experiencing, you may participate in more than one type of rehabilitative therapy. Starting therapy promptly can improve recovery, so be sure to start as soon as possible after symptoms appear.

Understanding Involuntary Movements Post-TBI

Traumatic brain injury involuntary movements can make it difficult to perform daily activities and continue with everyday life. Fortunately, the brain is capable of utilizing neuroplasticity to improve motor control. The most effective way to promote neuroplasticity is through high repetition of exercises.

We hope this article helped you understand the most common types of TBI involuntary movements, and the best ways to promote recovery.

The post Traumatic Brain Injury Involuntary Movements: Causes, Types, and Treatment appeared first on Flint Rehab.

Imagine looking at a familiar object—a coffee cup, a set of keys, or even a loved one’s face—and not being able to identify what it is, despite seeing it clearly. This perplexing experience is at the core of a condition known as visual agnosia. People with visual agnosia can see objects clearly, but they struggle to identify or name them. This disorder is not related to vision problems, memory loss, or language impairments. Instead, it results from damage to specific areas of the brain responsible for processing visual information.

In the following sections, we’ll look at the different types of visual agnosia, explore their causes and symptoms, and provide tips on how to manage the condition during recovery.

Types of Visual Agnosia

Visual agnosia can show up in different ways, making it hard for people to recognize things, even though they can see them clearly. Each type of visual agnosia affects people differently, which is why it’s important to understand the various forms. Knowing the specific type can help identify what kind of challenges someone might face and how best to support them with the right treatments.

Visual agnosias can be broken into a few main categories: 

• General visual agnosia: the inability to recognize known objects by sight
• Selective visual agnosia: the inability to recognize specific types of objects by sight, such as faces or written words

These types can be further broken into:

• Apperceptive visual agnosia: difficulty forming a coherent visual perception. Individuals struggle to recognize shapes, differentiate objects, or copy drawings. This type is often associated with damage to the occipital lobe, where initial visual processing occurs.
• Associative visual agnosia: inability to identify an object, despite intact visual perception. Individuals may be able to describe an object’s features—such as its shape, color, and size—but fail to identify what it is. This form often results from damage to the temporal lobe, where the brain connects visual input with stored knowledge.

Other types of visual agnosia, based on the kinds of recognition difficulties people might experience, include:

1. Prosopagnosia (Face Blindness)

Prosopagnosia is a selective visual agnosia where individuals cannot recognize familiar faces, including their own reflection in severe cases. This condition can be congenital (present from birth) or acquired due to brain injury.

• Apperceptive Prosopagnosia: Difficulty recognizing facial expressions or nonverbal cues.
• Associative Prosopagnosia: Inability to recognize familiar faces, though recognition through voice or other cues remains intact.

2. Topographical Agnosia

People with topographical agnosia cannot recognize familiar places or navigate their environment effectively. This selective visual agnosia, which also includes landmark agnosia and is closely related to environmental agnosia, often occurs alongside damage to the parahippocampal gyrus, which helps process spatial memory and navigation.

3. Akinetopsia

Individuals with akinetopsia can recognize objects but cannot perceive motion. They may see the world as a series of static images.

4. Alexia

Alexia affects the ability to recognize written words. Individuals can see words clearly but cannot read them, although their writing and speaking abilities remain unaffected.

5. Amusia

Amusia, in its visual form, causes an inability to read musical notation, even though auditory processing of music may remain unaffected.

6. Autotopagnosia

Autotopagnosia involves difficulty recognizing body parts, either one’s own or others’. A subtype, finger agnosia, refers to the inability to recognize fingers specifically.

7. Cerebral Achromatopsia

Also known as color agnosia, individuals with achromatopsia can distinguish different colors but cannot identify or name them.

8. Social-Emotional Agnosia

Social-emotional agnosia results in difficulty recognizing nonverbal social cues, such as body language or facial expressions, affecting social interactions.

9. Balint Syndrome

Balint syndrome affects the ability to perceive the visual environment as a whole. People with this condition see only isolated objects without understanding how they relate to each other. One of the three primary characteristics of Balint syndrome is a general visual agnosia known as simultagnosia. This affects the ability to visually perceive multiple objects at once. Other features of Balint syndrome include: 

• Optic ataxia: lack of coordination between vision and hand movement when reaching 
• Ocular apraxia: difficulty with coordinated voluntary eye movement

10. Simultanagnosia

Simultanagnosia impairs the ability to perceive more than one object at a time. There are two types:

• Dorsal Simultanagnosia: Only one object can be seen at a time, and other objects disappear from perception when not in focus.
• Ventral Simultanagnosia: Multiple objects can be seen simultaneously, but they can only be identified individually, not as part of a whole scene.

11. Form Agnosia

Individuals with form agnosia have trouble recognizing simple shapes. Since objects are often made of multiple shapes put together, this makes it very difficult to identify an object’s entire structure. However, they can identify specific visual features, such as color and motion. This is considered a general apperceptive visual agnosia.

12. Integrative Agnosia

Those with integrative agnosia are able to perceive different components of an object, but may be unable to integrate them together to see the object as a whole.

13. Transformation Agnosia

This general visual agnosia involves the inability to recognize three dimensional objects when viewed from an unusual viewpoint. It may also be referred to as spatial agnosia.

14. Orientation Agnosia

Also called agnosia for object orientation, this involves the inability to recognize which direction an object is oriented, despite still being able to identify the object. For example, although individuals with orientation agnosia may be able to identify a picture of a penguin placed in front of them in any orientation, they may not be able to identify whether the penguin is upside down or right side up. This can be caused by damage to the right parietal lobe.

Causes of Visual Agnosia

Visual agnosia typically results from brain damage that affects the occipital or temporal lobes, but may also result from damage to other areas. Common causes include:

• Stroke: A leading cause due to restricted blood flow causing brain cell death.
• Traumatic Brain Injury (TBI): Head injuries from accidents can damage visual processing areas.
• Neurodegenerative Diseases: Conditions like Alzheimer’s disease can gradually impair visual recognition.
• Infections: Encephalitis and other infections can cause inflammation and damage brain tissue.
• Tumors: Brain tumors pressing on visual processing areas can lead to agnosia.

Symptoms of Visual Agnosia

Symptoms vary based on the type and severity of the condition but may include:

• Difficulty recognizing common objects, even though they can be described in detail
• Inability to recognize familiar faces (prosopagnosia)
• Trouble identifying places or navigating familiar routes
• Problems copying or drawing simple shapes (in apperceptive agnosia)

Diagnosis of Visual Agnosia

Diagnosing visual agnosia involves a combination of clinical evaluation and diagnostic tests:

1. Neurological Examination

A doctor assesses visual acuity, cognitive function, and the ability to recognize objects, faces, and shapes.

2. Imaging Tests

MRI or CT scans help identify brain damage, lesions, or abnormalities in areas related to visual processing.

3. Neuropsychological Testing

Specialized assessments evaluate visual perception, memory, and recognition abilities to pinpoint the type of agnosia.

Treatment and Management of Visual Agnosia

There is no cure for visual agnosia, but treatment focuses on managing symptoms, enhancing visual processing, and improving daily functioning. A comprehensive approach often involves a combination of therapies, assistive tools, and support strategies tailored to the individual’s specific needs.

1. Occupational Therapy

Occupational therapy plays a key role in helping individuals with visual agnosia adapt to daily life challenges. With consistent support, occupational therapy can significantly enhance independence and confidence in performing everyday tasks.

Techniques include:

• Using Multisensory Cues: Incorporating touch, sound, and contextual information to assist object recognition. For example, identifying an object by its texture or associated sound.
• Environmental Modifications: Organizing living spaces with labeled items, consistent layouts, and visual cues to reduce confusion. Color-coding and clear labeling can aid recognition.
• Task Simplification: Breaking tasks into smaller, manageable steps to enhance understanding, helping individuals focus on one component at a time to build familiarity.

With consistent occupational therapy and focus on practical skills, individuals can regain a sense of control and autonomy in their daily routines.

2. Cognitive Rehabilitation

Cognitive rehabilitation focuses on strengthening the brain’s ability to process visual information more effectively. The goal is to help individuals rebuild connections in the brain that support visual processing and recognition.

This may involve:

• Visual Perception Training: Exercises designed to strengthen the ability to recognize shapes, patterns, and objects. This could include matching games, puzzles, and drawing tasks.
• Memory Association Techniques: Teaching individuals to link visual stimuli with familiar memories or verbal cues, creating strong mental associations to support recognition.
• Attention Enhancement Strategies: Improving focus and concentration to aid in visual interpretation. Mindfulness exercises and concentration drills can be effective.

Over time, these cognitive exercises can lead to noticeable improvements in visual recognition and daily functioning. 

3. Assistive Technologies and Supportive Aids

Modern technology offers several tools that can support people with visual agnosia in recognizing objects and navigating their environment. When used effectively, these tools can bridge the gap between visual limitations and daily life activities.

Some examples of technological aids can significantly enhance the quality of life for individuals with visual agnosia include:

• Speech-to-Text Applications: Tools that convert written text to spoken words, assisting those with alexia, enabling them to “hear” the written content.
• Augmented Reality Devices: Wearable technology that overlays information to aid recognition of objects and faces, offering real-time support in identifying surroundings.
• Customized Visual Aids: High-contrast images, color-coded items, tactile markers, and personalized flashcards to support visual identification and reinforce learning.

Continuous advancements in technology also offer new possibilities for enhancing visual recognition and independence.

4. Psychotherapy and Emotional Support

Addressing the emotional impact of visual agnosia is crucial for overall well-being, making psychotherapy an important part of treatment. Emotional resilience gained through therapy can greatly improve a person’s ability to manage the condition and maintain healthy relationships. 

Examples of psychotherapy treatments that can help individuals cope with frustration, anxiety, and social difficulties include:

• Cognitive-Behavioral Therapy (CBT): Assists in managing negative emotions, fostering adaptive coping mechanisms.
• Support Groups: Provide a platform to share experiences and strategies, reducing feelings of isolation and promoting community support.
• Family Counseling: Helps relatives understand the condition and learn how to provide effective emotional support.

Addressing the psychological impact is as important as treating the cognitive symptoms, making this an important part of management and treatment.

5. Addressing Underlying Conditions

Managing the health issues that cause or contribute to visual agnosia is essential for effective treatment. Addressing these root causes can sometimes reduce the severity of visual agnosia symptoms and improve overall neurological health.

Managing the root cause of visual agnosia may include:

• Medical Treatment: Addressing conditions like strokes, infections, or tumors through medication, surgery, or therapy to prevent further damage.
• Neuroprotective Interventions: Strategies to slow the progression of neurodegenerative diseases, such as Alzheimer’s, including medication, cognitive exercises, and lifestyle changes.
• Rehabilitation Programs: Comprehensive rehabilitation plans to support recovery after brain injuries or strokes, involving a multidisciplinary team.

Early intervention and ongoing medical care are key to preventing further complications and optimizing recovery.

6. Family and Caregiver Involvement

Support from family members and caregivers can greatly improve the quality of life for individuals with visual agnosia. Their involvement fosters a nurturing environment where individuals feel understood, supported, and empowered. 

Training and education for family members and caregivers can include:

• Communication Techniques: Using clear, descriptive language and non-visual cues, such as verbal descriptions or gestures, to aid understanding.
• Patience and Understanding: Recognizing the individual’s challenges and offering encouragement without frustration, creating a positive and supportive atmosphere.
• Structured Routines: Establishing consistent daily routines to minimize confusion and promote a sense of security.

Taking the time to understand the difficulties a loved one may be going through can not only improve their quality of life but also your ability to care for them. Many therapists provide personalized family and caregiver training throughout the individual’s recovery to optimize their ability to function in their home environment.

Visual Agnosia Final Thoughts

While visual agnosia undoubtedly presents challenges, early diagnosis, tailored therapy, and supportive strategies can significantly improve the quality of life for those affected. If you or someone you know experiences symptoms of visual agnosia, consulting a healthcare professional for evaluation and guidance is essential. 

Understanding the condition is the first step toward managing its impact. And with the right support, individuals can find new ways to adapt and maintain a fulfilling life.

Did you know there are different types of agnosia other than just visual? Check out our recent article to learn more about the different types of agnosia.

The post Visual Agnosia: Understanding the Condition, Causes, and Treatment Options appeared first on Flint Rehab.

In this blog, we’ll explore how TBIs can impact mental health and share 9 simple, practical strategies to help you feel more balanced, supported, and in control of your emotional well-being. Let’s get started!

Understanding the Link Between TBI and Mental Health

A traumatic brain injury occurs when a sudden impact or blow to the head damages the brain. TBIs can range from mild concussions to severe injuries, but regardless of severity, they can cause changes to your mood and mental health.

The brain controls not only physical functions but also emotions, behavior, and thinking. So, when parts of the brain responsible for emotional regulation are injured, it can lead to mood swings, depression, and feelings of hopelessness.

Why Does a TBI Affect Mental Health?

Here is a quick overview of how a TBI can affect mental health.

• Physical Brain Damage: Injury to brain regions like the frontal lobe, which regulates emotions and decision-making, can cause mood changes.
• Chemical Changes: A TBI can disrupt brain chemicals like serotonin and dopamine, which play key roles in mood regulation.
• Life Adjustments: Recovering from a TBI often means adjusting to new challenges in physical ability, memory, or daily routines. These changes can be emotionally overwhelming.

Understanding why these mental health struggles occur can help you and your loved ones respond with patience, understanding, and support.

Common Mental Health Challenges After a TBI

If you’ve experienced a TBI, you may notice emotional and psychological changes. Some of the most common challenges include:

Depression

Depression is a common issue for individuals recovering from brain injury. In fact, it is estimated that between 25 and 50% of all TBI survivors experience depression during the first year after their injury. It can include:

• Persistent sadness or emptiness
• Loss of interest in activities you used to enjoy
• Fatigue or lack of energy
• Difficulty concentrating or making decisions
• Feelings of hopelessness

Severe depression may lead to thoughts of suicide. Suicidal ideation may affect over 20% of TBI survivors, and even sustaining a mild brain injury can increase the risk of suicide by over 80%. If you or a loved one are experiencing thoughts of suicide, contact your national suicide hotline, which can be reached by calling or texting 988 in the United States.

Mood Swings

Mood swings can occur when emotions shift quickly or feel out of control. For example, you may feel happy one moment and suddenly become irritated or sad without clear reason. These mood swings can feel unpredictable and frustrating for both you and your loved ones.

Anxiety

After a TBI, nearly 20% of survivors experience anxiety. You might feel excessively worried, fearful, or stressed about things that didn’t bother you before. This can make it hard to relax or focus on recovery.

Understanding these challenges is the first step to addressing them and improving your quality of life.

TBI and Mental Health: 9 Strategies to Overcome Depression and Mood Swings After Brain Injury

Strategies to Overcome Depression After a Brain Injury

While overcoming depression after a TBI can be challenging, there are strategies that can help. These approaches focus on small, manageable steps toward improving your mood and mental health.

1. Seek Professional Support

Speaking with a mental health professional can make a big difference. A therapist or counselor can help you process your emotions and develop coping strategies tailored to your situation. Some approaches to therapy include:

• Cognitive Behavioral Therapy (CBT): Helps you identify and challenge negative thought patterns.
• Psychotherapy: Provides a safe space to share feelings and experiences.
• Medication: For some people, antidepressants prescribed by a doctor can help balance brain chemicals.

2. Build a Routine

After a brain injury, establishing a daily routine can help you feel more stable and in control. Try to include:

• Regular sleep and wake times, including good sleep hygiene
• Time for exercise and hobbies
• Structured meal times

A routine can provide consistency, which can reduce feelings of overwhelm or unpredictability.

3. Stay Physically Active

Exercise is a proven way to boost mood and reduce depression. It releases chemicals in your brain, like endorphins, that improve how you feel. Start with gentle activities like:

• Walking for 10-15 minutes daily
• Gentle stretching or yoga
• Light swimming or cycling

Speak to your doctor about safe exercises for your level of recovery.

4. Connect With Loved Ones

Social support is essential for emotional well-being. Spending time with friends, family, or support groups can help you feel less alone.

If talking in person feels overwhelming, consider connecting through phone calls or online platforms. Additionally, you can work to find activities that you enjoy and can do together.

5. Practice Mindfulness and Relaxation

Mindfulness techniques can help you stay calm and reduce stress. Try practices like:

• Deep Breathing: Inhale deeply through your nose, hold for a few seconds, and exhale slowly.
• Meditation: Spend 5-10 minutes focusing on your breath or a calming image.
• Body Scans: Pay attention to how your body feels, releasing tension where needed.

Mindfulness is a simple, powerful tool that can help improve emotional regulation. It can be practiced anywhere, at any time. Some find that using an app, such as Headspace, can help guide and focus mindfulness practices, making them even more effective.

Strategies to Manage Mood Swings After a TBI

Mood swings can feel frustrating, but there are ways to manage them effectively. By understanding your triggers and using healthy coping strategies, you can reduce their frequency and impact.

1. Recognize Your Triggers

Pay attention to what causes your mood swings. Common triggers can include:

• Fatigue or lack of sleep
• Stressful situations or overstimulation
• Certain environments (e.g., loud or busy spaces)
• Physical pain or discomfort

Keeping a journal can help you identify patterns and better understand your emotional responses.

2. Use Emotional Regulation Techniques

When you feel a mood swing coming on, try using emotional regulation strategies like:

• Pause and Breathe: Take slow, deep breaths to calm your body and mind.
• Walk Away: If you’re feeling overwhelmed, step away from the situation for a few moments.
• Count to 10: This simple act gives your brain time to reset before responding emotionally.

It can take time to build a habit of regulating your emotions before responding. However, with practice, these simple techniques can help you to modulate your mood and adjust your responses.

3. Engage in Calming Activities

Activities that relax your body and mind can help balance your emotions. Consider:

• Listening to soothing music
• Drawing, painting, or journaling
• Spending time in nature
• Reading a calming book

These activities can distract you from negative emotions and provide healthy outlets for expression.

4. Practice Self-Compassion

Managing mood swings after a brain injury takes time. Be kind to yourself when you have a difficult day. Remind yourself that you are healing, and progress takes small, steady steps.

Supporting Someone With TBI and Mental Health Challenges

If you’re a caregiver, family member, or friend of someone recovering from a TBI, your support matters. Here are ways you can help:

Be Patient and Understanding

Mood swings and depression can be symptoms of the injury, not personal behavior. Try to:

• Stay calm during emotional outbursts
• Offer reassurance and a listening ear
• Avoid blaming or criticizing

Encourage Professional Help

Gently encourage your loved one to seek support from doctors, therapists, or support groups. Offer to help schedule appointments or accompany them to visits if needed.

Promote Healthy Habits

Support healthy routines by helping your loved one:

• Stick to a regular sleep schedule
• Plan healthy meals
• Engage in light physical activities

Take Care of Yourself

Caring for someone with a TBI can be emotionally challenging. Make sure to prioritize your own well-being by taking breaks, asking for help when needed, and practicing self-care. There are also support groups available for caregivers of TBI survivors, which can allow you to share your experiences and learn from others.

The Role of a Healthy Lifestyle in Emotional Recovery

A healthy lifestyle can support both physical and emotional recovery after a brain injury. Here are some key areas to focus on:

Nutrition

A balanced diet can support brain function and improve mood. Include:

• Fresh fruits and vegetables
• Whole grains
• Lean proteins (e.g., chicken, fish, beans/legumes)
• Healthy fats (e.g., nuts, avocado, olive oil)

Avoid too much sugar, caffeine, or processed foods, as they can negatively affect energy levels and mood.

Sleep

Sleep is essential for brain healing and emotional balance. Tips for improving sleep include:

• Going to bed and waking up at the same time every day
• Creating a calm bedtime routine
• Avoiding screens (TV, phones, tablets) 1 hour before sleep

Hydration

Staying hydrated is simple but important. Dehydration can cause fatigue and irritability, so aim to drink plenty of water throughout the day.

Finding Hope and Moving Forward

Recovery after a TBI takes time, patience, and effort. While mental health challenges like depression and mood swings can feel overwhelming, there are tools and strategies that can help you feel better. Remember:

• Progress Happens Slowly: Small improvements add up over time. Celebrate every step forward, no matter how small. Keep a journal to look back on so you can see where you’ve grown.
• You Are Not Alone: Many people have faced similar challenges and found ways to overcome them.
• Support Is Available: Whether through professional help, loved ones, or support groups, you have people who care about you and want to help.

By taking it one day at a time and focusing on strategies that work for you, it is possible to feel better, regain control of your emotions, and rebuild a fulfilling life after brain injury.

Traumatic Brain Injury and Mental Health

Mental health struggles like depression and mood swings are common after a traumatic brain injury, but they don’t have to define your recovery journey. By understanding the connection between TBI and mental health and using strategies like professional support, healthy routines, and emotional regulation techniques, you can make progress toward feeling better.

If you or someone you love is navigating these challenges, remember that healing is a process. Stay patient, ask for help when needed, and take small steps each day. You are not alone in this journey, and hope is always within reach.

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In this article, you will learn some of the causes and effects of high blood pressure, also referred to as hypertension, after a brain injury or concussion. We will explain why controlling your blood pressure can help improve cognitive function.

Parts of the Brain that Regulate Blood Pressure

Blood pressure varies by heart function, salt and water retention, and the diameter of blood vessels. When the heart’s left ventricle contracts, it forces oxygen-rich blood through your arteries to every body part via the network of vessels. These vessels can be more constricted or dilated in response to various physiological factors.

The brain also plays a role in determining blood pressure. Specifically, the brain stem helps regulate cardiac output and adjusts blood vessel diameter.

How the Brain Stem Controls Blood Pressure

The medulla oblongata is the part of the brain stem in charge of cardiac function. The medulla receives information from baroreceptors that monitor arterial blood pressure.

If blood pressure gets too high or too low, these receptors send signals to the medulla. The medulla, in turn, causes the arteries to dilate or constrict, depending on what the body needs.

When the arteries dilate, this lowers the overall pressure that the heart has to overcome to successfully pump the blood through the vessels. Thus, the brain can lower the body’s blood pressure by dilating the arteries.

In addition, the brain stem also receives signals from higher brain regions, such as the limbic system. In stressful conditions, these areas signal the medulla to constrict the arteries and raise blood pressure.

Causes of High Blood Pressure After Head Injury

Now that you understand how the brain controls blood pressure, we can discuss some of the causes of high blood pressure after head injury.

There are two main causes of high blood pressure after a TBI:

• The medulla can no longer detect signals from the baroreceptors telling it to dilate the arteries.
• Damage to the rest of the brain makes the brain stem think the body is in distress, causing it to raise blood pressure.

Blood pressure might also rise because the body releases an excess of catecholamines into the bloodstream after a brain injury. Catecholamines are stress hormones that cause the heart to pump harder and faster to send more blood to major organs, including the brain.

If high blood pressure lasts for too long, it can cause serious problems, which we’ll look at next.

Symptoms of High Blood Pressure

Most high blood pressure is asymptomatic (without symptoms), which is why it is sometimes called the “silent killer.” Because of this, it is generally advised to check blood pressure regularly even if you don’t have symptoms. Occasionally, blood pressure can cause overt symptoms, which could include:

• Fatigue
• Confusion
• Increased irritability
• Severe headache
• Difficulty breathing
• Chest pain

However, the most common effects of long-term high blood pressure are its effect on heart health, increased risk of stroke, and various organ health. There is also evidence that hypertension can negatively impact cognitive function. Research shows that patients with high blood pressure perform more poorly on tests that measure memory, attention, and executive function.

This may occur because high blood pressure diminishes cerebral blood flow and metabolism. If your brain cannot get enough oxygen from the blood, it won’t function as efficiently.

Finally, prolonged elevated blood pressure is also associated with cognitive decline and vascular dementia, and increases your risk of suffering a stroke. All of this shows why it is crucial to get your blood pressure under control after a head injury.

Treating High Blood Pressure After Head Injury

While medication is often effective at lowering blood pressure, it is generally prescribed after other methods have failed. Some of the side effects of blood pressure pills can be dangerous.

Fortunately, several lifestyle changes can help you lower your blood pressure after a head injury.

1. Increase Activity

With increased activity, your body adapts by relaxing the smooth muscles in your arteries leading to vasodilation. In addition, exercise strengthens the heart, which means it can pump with less effort. This puts less strain on your arteries and will lower your blood pressure.

The American Heart Association recommends that people practice moderate physical activity for at least 40 minutes, three to four times per week.

These 40 minutes don’t have to all be in one session, and they don’t have to be as intense as running a marathon. Some examples of activities you can do include:

• Walks around your neighborhood
• Taking the stairs
• Short bike rides
• Gardening

Again, nothing too strenuous, but enough to elevate your heart rate.

You may be wondering if exercise is safe after a head injury. Although doctors used to advise their patients to avoid all strenuous activity for weeks after a TBI, the science no longer supports that idea.

In fact, moderate exercise can actually improve cognitive recovery in patients with head injuries.

Of course, you should not overdo it. If exercising causes you excessive fatigue or headaches, back off your intensity. Try slowly building up your tolerance by starting with five-minute sessions (or less!) and working your way from there.

The more active you stay, the healthier you will be, which will help both your cognitive function and blood pressure.

2. Change Your Diet

Changing your diet will help you lower your high blood pressure after head injury. Specifically, you will want to increase potassium intake and cut down on sodium.

Potassium helps lessen the effect of salt in your body and eases tension in the blood vessels, both of which will reduce your blood pressure. Some foods that are naturally high in potassium include:

• Bananas
• Avocados
• Sweet potatoes
• Tomatoes
• Fish
• Reduced-fat milk and yogurt

Many of the foods that heal the brain after a concussion are also low in sodium and high in potassium. So try to add those to your diet as well.

3. Practice Mindfulness

Mindfulness and meditation techniques are both effective methods for lowering blood pressure after head injury.

Mindfulness simply means staying mentally present to your surroundings and the current moment. This helps you ignore the constant chatter that our brains normally produce, which is often the source of our stress and anxiety.

To stay mentally present, it helps to have a point of focus that pulls your attention to your body. For most people, this point of focus is their breath.

When your mind focuses on your breath, it’s much harder for thoughts and worries to get in. It gives you a chance to step back from the constant tailspin of anxiety and observe what you are feeling with a clear mind.

Mindfulness is one of the principles behind yoga, which is an excellent technique for reducing blood pressure.

In fact, studies have found that yoga practices can decrease diastolic blood pressure by 3.6 mmHg, which is comparable to many blood pressure medications.

High Blood Pressure After Head Injury: Key Points

High blood pressure is a rare but serious secondary effect of head injury. If left untreated, it can lead to cognitive decline and increase your risk of stroke as well as a variety of other health concerns.

Treating high blood pressure may also help improve mental clarity after a head injury. Therefore, if no other treatments are helping, get your blood pressure checked. It may be making your cognitive function worse.

Lifestyle changes such as meditation, exercise, and a healthy diet can all help lower blood pressure. If these changes do not work, some medications may need to be prescribed by your doctor.

As always, talk with your doctor before starting any new drugs or making any changes in your diet. They can help you make the best decision for your health.

The post High Blood Pressure After Head Injury: Causes, Symptoms, and Treatment appeared first on Flint Rehab.

Because spasticity is a problem originating from the brain, treatments must engage neuroplasticity, the brain’s natural repair mechanism, to be effective.

In this article, you will learn more about the causes of spasticity after TBI, plus the best ways to reduce it. You will also discover how to treat muscles that have been affected by spasticity.

Causes of Spasticity After TBI

Spasticity is associated with a condition called hyperreflexia, which is increased activity of the reflexes that normally occur in muscles. This reflex is actually a muscle contraction that occurs when the muscle is stretched or lengthened.

When you stretch a muscle, receptors within the muscle are activated which stimulate motor neurons to cause a contraction to prevent the muscles from stretching too far and tearing.

This reflexive process is overridden or controlled by the central nervous system (i.e. the brain and spinal cord). Normally, the muscles and the brain send messages to each other through the spinal cord.

However, after a brain injury, this communication is disrupted, which leads to an imbalance of signals. As a result, the reflex is never turned off, resulting in a constant state of contraction. This state is what doctors refer to as spasticity.

Signs and Symptoms of Spasticity

Spasticity after TBI primarily results in muscle stiffness. If the spasticity persists, the muscle adapts and is permanently shortened, leading to contractures and loss of mobility.

Other signs of spasticity can include:

• Muscle spasms
• Joint deformity
• Muscle fatigue
• Involuntary crossing of legs

Fortunately, you can prevent many of these with early intervention for spasticity.

Engaging Neuroplasticity to Treat Spasticity after TBI

The most effective way to overcome spasticity after TBI is to address the root cause. Since the cause of spasticity is poor communication between the brain and muscles, treating it must involve restoring that connection. You can do this by engaging a process known as neuroplasticity.  

Neuroplasticity refers to the brain’s ability to rewire itself and create new neural pathways. This allows undamaged areas of the brain to take over functions from damaged ones.

These new pathways are formed when your brain gets stimulated by effortful, repetitive, therapeutic exercise. Therefore, the best way to treat your spasticity is to attempt to exercise your affected muscles.

Even imagining movements, but especially activating your muscles will reinforce new neural pathways. The goal is to improve the communication between your brain and muscles and, eventually, lessen spasticity.

But what if your spasticity is so severe you cannot even move your muscles at all? Fortunately, there are alternative treatments for you to try.

Treating Severe Spasticity After TBI

Spasticity can resolve on its own as the brain heals. But in some cases, spasticity is so severe that the opposing muscle groups are unable to overcome the spastic ones This can make engaging neuroplasticity much more difficult.

However, there are therapeutic treatments to consider – here are two common options.

Stretching and Passive Range-of-Motion

Stretching and passive range of motion exercises can help minimize the effects of spasticity after TBI. Stretches are important for preventing contractures, which preserves joint mobility. Keeping muscles limber also prepares the joint for even the weakest movement attempts.

Passive exercises come with an additional benefit though, in that they can also activate neuroplasticity. In fact, neuroimaging studies have found that passive movement exercises activate the primary motor cortex, the part of the brain responsible for voluntary movement.

Therefore, having a therapist or a family member move your arm or leg for you can help repair the brain’s connection to controlling your muscles. And the stronger the communication, the less spasticity you will experience.

Botox Injections and Baclofen Pumps

For patients with spasticity in a single location, Botox injections can prove useful. Botox is a nerve blocking agent that prevents the release of acetylcholine, a neurotransmitter that causes your muscles to contract.

This medication can almost instantly stop painful spasms, which makes it a popular treatment choice for more serious cases. For people with severe and painful spasticity, it is a good option.

If, on the other hand, your spasticity affects many body parts at once, a baclofen pump will probably prove to be more effective. A baclofen pump refers to a small, hockey-puck-sized device implanted beneath the skin. The device then releases small amounts of baclofen into the space surrounding the spinal cord. This allows the medication to impact multiple muscle groups at once.

However, both baclofen and Botox are only temporary solutions. Once their effects wear off, the spasticity will return. For the most effective approach, patients should combine these medications with passive range of motion exercises or active exercise when possible. This is the only way to engage the brain and stimulate neuroplasticity.

Understanding Spasticity After TBI

Spasticity after TBI can be a painful condition. However, it is treatable.  

If your spasticity does not allow you to move on your own, consider combining passive range-of-motion exercises with medication. Although you are not moving yourself, the passive exercise still engages plasticity within the brain. This will help repair the neural connections between the brain and muscles.

As communication improves within the central nervous system, your spasticity should decrease. With enough persistence, you can hopefully train your muscles to relax again.

The post Spasticity After TBI: Causes, Symptoms, and Treatments appeared first on Flint Rehab.

This condition, also known as flat affect, is caused by damage to the frontal lobe of the brain. Depression and other emotional problems can also contribute, however to brain injury lack of emotion.

This article will discuss the causes and symptoms of brain injury lack of emotion and how to treat it.

What Causes Flat Affect After Brain Injury?

The area of the brain most involved in emotion is called the limbic system. This system includes three important structures within the brain:

• The hypothalamus
• The amygdala
• The hippocampus

These structures help the brain control emotional responses. They are what allow us to react appropriately to emotional situations. Thus, if a brain injury damages these structures, the person may lose control of their emotions.

Another part of the brain that plays a role in emotion is the cingulate cortex, which connects to the limbic system. The cingulate cortex helps translate emotions into facial expressions.

Therefore, if this cortex becomes damaged, a person will have trouble expressing emotions with their face and voice. Psychologists call this lack of emotional expressiveness after brain injury “flat affect” because the person’s voice often also has a flat, monotonous sound.

Other Reasons Why Someone May Lack Emotional Expression

Not every TBI survivor who shows a lack of emotion has a flat affect. Other conditions that can cause similar symptoms after brain injury include:

• Depression. Depression is unfortunately common after brain injury and can interfere with the way the brain processes emotion. This causes people to lose interest in things that they used to enjoy, which makes them seem detached and apathetic.
• PTSD (Post-traumatic stress disorder). This disorder is also common after brain injury. One of the main symptoms of PTSD is emotional suppression and withdrawal.
• Facial paralysis. Sometimes brain injury can damage the nerves that control facial expression. This can make it difficult for the person to display emotions through their facial expressions.

In addition, some medications can also impact the way a person feels and shows emotion.

Symptoms of Flat Affect

Persons who experience flat affect after brain injury often show certain symptoms, such as:

• Monotone speaking
• No change in facial expression
• Avoidance of eye contact
• Neutral body language (i.e. relaxed and staying still in a situation where they should be tense)

It’s important to realize that patients with flat affect can still experience emotions, they have simply lost the ability to express themselves.

People with brain injury can also develop a condition known as blunted affect or “emotional blunting.”  Symptoms of blunted affect are similar to flat affect, but instead of showing no emotions, the person’s expressions are simply restrained.

Blunted affect is most common in patients with PTSD.

These symptoms can make the person appear as though they do not care about anything or other people. But for most brain injury patients, this is not true. They do care, they just are having difficulty showing it.

Treating Flat Affect After Brain Injury

The best way to treat flat affect after brain injury is to address the root causes.

For example, your depression or PTSD may be causing the emotional problems. Addressing them with a therapist and medication may help lift your flat affect.

Sometimes, flat affect can occur jointly with other cognitive effects that make it difficult for patients to understand which emotions they feel. In those cases, cognitive-behavioral therapy can be useful.

Using Cognitive-Behavioral Therapy for Flat Affect

Cognitive-Behavioral therapists can teach patients  to identify their emotions and react appropriately. They do this through a series of exercises that help a person better understand their behavior and the emotions that might have lead to that behavior.

Cognitive-behavioral therapy can also retrain people to use facial expressions. For example, a therapist might teach you to smile and make eye contact when you say hello to someone.

The more you practice these behaviors, the more you will rewire your brain until these actions occur naturally again.

Speech Therapy

Another therapy that can help someone overcome flat affect is speech therapy. Specifically, speech therapy can help you eliminate a monotone voice.

A monotone voice usually occurs after a right hemisphere injury. Just as the right hemisphere controls a person’s awareness and appreciation of music, it also plays a part in the way we speak.

When a person suffers damage to the right side of their brain, not only can their ability to appreciate music be diminished, but they may also have trouble picking up on the subtle changes in pitch or tone during speech. This diminished musical ability can cause the person to sound monotone when speaking, giving them an almost robotic voice.

Speech therapists can help you regain the ability to control the pitch and tone of your voice. They do this through melodic intonation therapy (a.k.a. music therapy).

Once again, the more you practice any skill including music therapy, the better you will get at controlling your voice. That’s the power of neuroplasticity! 

Caring for Someone With Flat Affect After Brain Injury

When a loved one has a flat affect, it can often feel like they have become cold and withdrawn, which puts a strain on relationships.

Remember that your loved one most likely is just as frustrated by their brain injury lack of emotion as you. As they struggle to translate their feelings into physical or verbal expressions, remember they still experience emotions and care.

It is helpful to realize this condition may impact your mental health. You might want to consider talking to a therapist familiar with brain injury. They can offer more personalized advice for coping with flat affect.

Overcoming Flat Affect After Brain Injury

Flat affect is a challenging symptom of brain injury. But fortunately, there is hope for recovery.

Whether your lack of emotional expression is caused by depression or brain damage, cognitive and speech therapy can help. By practicing emotional expression with a therapist, you may rewire the brain to express emotions again.

Even if you struggle to feel emotions, learning how to better communicate non-verbally can help improve important relationships in your life.

The post Flat Affect After Brain Injury: How to Overcome Lack of Emotional Expressiveness appeared first on Flint Rehab.

While foot drop can be associated with multiple conditions, foot drop after TBI is usually caused by a disruption in communication between the areas of the brain responsible for movement and the muscles involved in ankle mobility. When the brain cannot send the appropriate signals to the muscles to lift the foot, foot drop may occur.

Individuals with foot drop often experience difficulty walking and safely navigating daily activities. Fortunately, there are various treatment options available to help improve foot drop after TBI. Use the links below to jump directly to any section of this article to learn more.

• Causes
• Signs of foot drop
• Impact on daily activities
• Engaging neuroplasticity for recovery
• Treatments

Causes of Foot Drop After TBI

The motion of ankle dorsiflexion involves lifting the front portion of the foot upwards toward the shin. When an injury affects the ability to perform this motion, individuals may be diagnosed with foot drop. While the most common cause of foot drop is nerve injuries, it can also be a symptom of underlying muscular or neurological conditions, such as a traumatic brain injury.

In order to perform voluntary movements, a signal must be transmitted from the brain through the spinal cord and peripheral nerves to the targeted muscles. Disrupting this signal at any point may result in impaired movement. For example, foot drop most often occurs when a peripheral nerve injury in the leg disrupts communication between the brain and the leg muscles.

However, an injury to areas of the brain associated with ankle movement, such as the primary motor cortex, can also result in foot drop. Without the appropriate signals coming from the brain, the muscles associated with lifting the foot are not told when to contract. Furthermore, because the brain can’t tell these muscles to counteract the force of gravity pulling downward on the toes, foot drop occurs.

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Although foot drop is usually a direct result of a disruption in the brain’s signals to the targeted muscles, it can also be caused by muscle weakness. Because the causes of foot drop may vary, it’s important to consult with one’s doctor and obtain an accurate diagnosis.

Signs of Foot Drop After TBI

One of the most common signs of foot drop after a brain injury is ankle weakness. However, there are other symptoms that doctors or therapists may look for in order to make an accurate diagnosis.

Signs of foot drop after TBI can include:

• Toes curling toward the balls of the feet
• Persistent corns on the base of the foot
• Frequent stumbling and/or falls
• Changes in gait (manner of walking)

It is also common for individuals with foot drop to experience numbness or tingling in the top of the foot. This is especially common among those with a nerve injury or underlying neurological condition.

Impact of Foot Drop on Daily Activities

Difficulties with ankle dorsiflexion due to foot drop can impact participation in many activities, such as putting on shoes, getting into and out of the shower, and tapping the foot to music. However, the inability to perform ankle dorsiflexion is usually most evident when walking.

In order to walk safely and effectively, the heel usually hits the ground before the toes when stepping forward. If the toes are unable to be raised, they either drag when stepping or hit the ground first.

To combat this, individuals may change their gait pattern (how they walk). Many develop a steppage gait, where they raise the leg up higher at the hip and knee to keep the toes from dragging. This may almost make them look like they are climbing stairs rather than walking on a flat surface. A steppage gait requires more energy and may cause further injuries due to safety concerns and overexertion of the hip and back muscles.

Individuals should consult their doctor if they experience any new or recurring symptoms that may be related to foot drop. That way, they can more accurately determine the cause and administer the appropriate treatment.

Importance of Neuroplasticity for Recovery

Since foot drop after TBI often occurs as a result of impaired communication between the brain and the muscles involved in lifting the foot, restoring this communication pathway is essential for recovery. Fortunately, the brain has the natural ability to rewire itself by strengthening existing neural connections and creating new ones through a process known as neuroplasticity.

As neural connections are restored, the brain may be able to accurately send nerve signals to the affected muscles, improving mobility and overall function. To activate neuroplasticity, it is vital to consistently and repetitively practice targeted exercises involving lost functions. The more a movement is practiced, the more the brain will reinforce and strengthen the neural connections required for that function.

Treating Foot Drop After TBI

Foot drop treatments that optimize neuroplasticity can be some of the most effective options. While a few common treatments for foot drop are listed below, it’s important for individuals to consult with their doctor and/or therapist for personalized recommendations.

Effective treatments for foot drop after TBI may include:

Foot Drop Exercises

To restore communication between the brain and the muscles of the leg, it is essential to rewire the brain through neuroplasticity to control dorsiflexion once again. The best way to achieve this is through frequently practicing targeted exercises, usually with the guidance of a physical therapist.

Even minimal movement is beneficial and can help stimulate recovery. In fact, individuals who are unable to actively dorsiflex their ankle at all can improve foot drop by supporting their foot through correct movement patterns.

Recommended foot drop exercises may include:

• Passive ankle dorsiflexion: To complete this passive exercise, sit in a comfortable position and cross one leg over the other, so that the affected foot is easy to reach. Then, use the hands to bend the foot up towards the knee and back down.
• Assisted toe raises: In a seated position, place the front portion of the non-affected foot underneath the affected one. Then, use the stronger foot to lift the front portion of the affected foot, making sure to always keep both heels on the ground. Hold for a few seconds, then slowly lower the foot back down.
• Negative toe raises: After regaining some movement in the foot, start this exercise by pointing the toes up toward the body as much as possible. Then, instead of quickly letting the foot fall down, slowly lower the foot back to a neutral position.
• Ball lifts: Sit with both feet flat on the floor. Place a tennis ball on the floor and hold it between the feet. Then, using both feet, bend at the ankle to slowly raise and lower the ball.

As mobility improves, strengthening exercises using resistance bands can also be added. In addition to boosting recovery, keeping the foot and ankle moving is essential for improving blood flow, lowering the risk of contractures, and reducing the risk of learned non-use.

Functional Electrical Stimulation

While therapeutic exercises are usually the best way to promote neuroplasticity and improve foot drop after TBI, some survivors may benefit from additional treatments, such as functional electrical stimulation (FES). By sending small electrical impulses into the affected muscles of the leg, FES can create a muscle contraction similar to what would occur if the brain itself was telling the muscle to engage.

Reactivating these muscles through FES encourages mobility and engages neuroplasticity. Ideally, FES should be used in conjunction with therapeutic exercises to maximize the chances of recovery.

Ankle-Foot Orthotics (AFOs)

Because foot drop makes it difficult to move and walk safely, therapists often recommend using an ankle-foot orthotic, or AFO brace. AFOs provide support for the foot and ankle to prevent the toes from scuffing the floor when walking, lowering the risk of falls.

There are many types of AFOs available, including the Flex AFO recently developed by Flint Rehab. A physical therapist can be a great resource to help survivors determine which AFO brace is most suitable for their needs.

While AFOs can be helpful, they do not encourage recovery through neuroplasticity like the other treatments listed above. AFOs are considered compensatory tactics, which help to make up for lost functions without necessarily trying to improve those functions. Therefore, while AFOs can help individuals walk more safely and effectively, they are not good long-term replacements for those hoping to improve their ankle mobility.

This is because always using compensatory tactics, such as an AFO brace, can lead to learned non-use. When the muscles involved in lifting the foot are consistently unused due to being stabilized by an AFO brace, any remaining function in those muscles gradually deteriorates until the body has learned not to use those muscles at all.

To combat this, it is essential to take breaks from using the AFO and practice foot drop exercises. This will help stimulate the brain and activate neuroplasticity to promote recovery.

Surgery

Severe cases of foot drop may require surgical interventions. Different surgical treatments, such as nerve transfers and decompressive surgeries, can help improve dorsiflexion.

Nerve transfers involve taking “donor nerves” from other parts of the body and using them to connect the ends of the divided or damaged nerves. Decompressive surgery is a procedure that helps relieve pressure on the nerves, which can also help improve dorsiflexion.

These surgeries are generally most effective if there is an injury to the peripheral nerves in conjunction with a TBI, as may occur when the leg has also sustained trauma at the time of one’s injury. Because surgical interventions are highly invasive, they should only be considered when all other treatment options have been exhausted.

Recovering from Foot Drop After TBI

Foot drop after TBI can make it difficult to walk and safely navigate daily activities. The inability to lift the front portion of the foot (dorsiflexion) is caused by the disruption of signals between the brain and muscles.

The best way to recover from foot drop is to activate neuroplasticity and restore neural connections. This can be achieved by the consistent and repetitive practice of targeted exercises, both active and passive.

Still, many survivors benefit from using multiple treatment options, including AFO braces, electrical stimulation, and a variety of exercises. Therefore, it’s important for individuals to consult with their doctor to obtain an accurate diagnosis and rehabilitation plan.

The post Foot Drop After TBI: Understanding the Causes, Signs, & Treatment Options appeared first on Flint Rehab.

Today you will learn why a brain injury can lead to a lack of empathy, plus what therapies can help people regain their empathetic skills.

Causes of Lack of Empathy After Brain Injury

Empathy is the ability to see things from another person’s perspective and feel what they feel.

Many areas of the frontal lobe are essential to the execution of empathy. For example, the right supramarginal gyrus helps people overcome egocentric bias (self-centeredness) when making decisions. The orbitofrontal cortex is an area of the brain that helps us react to another person’s feelings. Therefore, if any of these brain regions become damaged, a lack of empathy can occur.

Other cognitive and behavioral problems that can accompany a lack of empathy after a brain injury include:

• Childish behavior
• Apathy or low motivation
• Disinhibition
• Aggressive behavior

It’s important to note that even though a person may display these behaviors, they may not be fully responsible for them. Family members and friends should try not to take their loved one’s words or actions too personally.

Alexithymia and Lack of Empathy

Sometimes TBI patients can still empathize with others, but they have trouble processing their emotions. This condition, called alexithymia, is also common in individuals with autism.

Alexithymia causes difficulties in identifying, describing, and processing one’s own emotions and those of others. It also makes it hard to distinguish bodily sensations from emotional feelings.

This can lead people to seem insensitive and non-empathetic when in fact they do experience the emotions of others. They just do not know how to react.

It can be difficult to distinguish alexithymia from a true lack of empathy. A neuropsychologist can provide a proper diagnosis and teach individuals ways to process emotions again.

Is Lack of Empathy After Brain Injury Permanent?

Some brain injury side effects, such as a lack of empathy, can go away on their own. As their frontal lobe injury heals, you may notice your loved one becoming more responsive to others again.

Even if this does not occur naturally, it may still be possible to relearn empathy. Empathy is a skill, and like all skills, it can be improved through deliberate practice.

This is what the field of positive psychology is based on. Positive psychology, as the name suggests, is a method used to help train the brain to rest in more positive states.

For instance, by writing in a gratitude journal daily, you can help train the brain to notice more things to be grateful for. The repetitive practice of searching for gratitude helps the brain become more efficient at the skill of noticing things to be grateful for.

Some research suggests that empathy can be learned, too. However, this research is broad. There are no studies specifically within the TBI field proving that practicing empathy helps improve empathy.

However, the principle of deliberate practice is clear: the brain becomes more efficient at the tasks that are repetitively practiced, including emotions. If your loved one is receptive to it, practicing empathy as a skill could be worth trying.

What If Empathy Never Returns?

Your loved one’s empathy skills may never return. However, that does not mean that they can never be compassionate again. To understand how this can be true, we will need to discuss how empathy works.

Most psychologists believe there are three different types of empathy:

• Cognitive empathy. The ability to understand the positions and feelings of others.
• Emotional empathy. The ability to share and experience the emotions of others.
• Compassionate empathy. The ability to respond to others and help them when they are in need.

Even if a person lacks cognitive or emotional empathy, they can still practice compassionate empathy. That’s because compassionate empathy involves actions and behavior, something most TBI survivors can more easily grasp. While cognitive and emotional empathy can make it much easier to practice compassionate empathy, it is possible to be compassionate without them.

Depending on how severe a person’s cognitive deficits are, it may require a lot of work to help them learn how to respond compassionately again. It can be especially difficult if they suffer from a lack of insight since that can make it hard for them to understand their own deficits.

However, with help from a behavioral therapist, individuals can learn how to control their behavior and recognize when to help others.

Dealing with Lack of Empathy After Brain Injury

Even though it is possible for TBI survivors to regain empathy, it will take time. In the meantime, here are some steps that family members can take to help their loved ones improve their empathy skills.

Provide Feedback

It’s important to give feedback to your loved one about their behavior. Otherwise, they will never improve. For example, gently let them know if they do something rude or inappropriate.

Try your best not to embarrass them, so it may have to be at a later time. But make sure they understand their need to increase their social efforts.  Most likely, they are unaware of their selfish behavior.

In the same way, if they show empathy and compassion, give them praise. Direct their attention to specific instances when they were considerate of another person, and congratulate them. This helps them learn which behaviors are positive and which are negative.

Develop Awareness

Second, try to direct your loved one’s attention to the feelings of others. This can help them develop a better awareness of another person’s emotions. Do this by asking them questions about others and talking with them about other people’s circumstances.

For example, if they see a mother at a store with three little children, try asking them what they think the mother is feeling. Is she stressed, tired, or anxious? Then, ask how they might feel if they had to take a child out shopping. This exercise can help them practice putting themselves in another’s place.

Nurture Social Skills

Brain injury lack of empathy can make it hard for individuals to maintain relationships. Therefore, they benefit from reminders to invest in their friendships, especially if they struggle with social skills.

Some things you can remind them to do include:

• Make phone calls, write letters, and text friends to keep in touch.
• Remember and acknowledge birthdays and special occasions.
• Initiate contact and suggest activities with family and friends.
• Say please and thank you, and take turns.
• Ask someone what they would like to do.

Again, the more the person can practice these skills, the more they will improve.

Don’t Take Things Personally

Individuals with low empathy can sometimes appear aggressive, dismissive, or demanding. If your loved one acts this way to you, don’t take it personally. Remember they are not in complete control. They have a lot more emotions and fewer inhibitions now, compared to before their injury.

Understanding Lack of Empathy After Brain Injury

A person who suffers a brain injury may experience a lack of empathy, especially if they have damage to their frontal lobe. Fortunately, the brain can often rewire to learn empathy again.

Even if empathy never returns, your loved one can still relearn how to practice compassion for others. While it might take a lot of patience and dedication, they can eventually improve.  

The post Understanding Lack of Empathy After Brain Injury and How to Cope appeared first on Flint Rehab.