Stroke Terminology

Stroke Terminology

There are a lot of medical latin-sounding words used to describe the different stroke symptoms. Below is a list together with the way that I remember them.

In brackets is (Ph) or (M) to indicate whether the symptom is physical or mental. Physical could be movement or sensation; and Mental means cognitive processes such as perception or attention.

Vision

Around 40% of the brain is actually involved with vision, since it includes ocular motor movement, planning of these movements, receipt of the visual information, processing of it and then decisions made on the visual information – these decisions could be visuospatial, emotional etc.

Hemianopia (Ph) (hemi=half;   plegia=paralysis)

Loss of vision in either L or R half of both eyes. So not loss of vision in left eye, but loss of left visual field in both eyes. The information from one side is not transmitted to the brain.

Neglect (M)

The information from eyes is being transmitted to the brain, but information for one side is ‘ignored’ or not processed by the brain.

Diplopia (Ph) (diplo=double; op=eye)

Double vision.

Nystagmus (Ph)

Continuous uncontrolled eye movements, seen with involuntary flickering movements of the eyes either L-R or up-down.

Motor movement

Apraxia or Dyspraxia (M) (a/dys=lack of;   praxis= to do; putting a thought into practice)

There is sufficient muscle strength to make voluntary movements, but the brain cannot plan or control the muscle movements to carry out a task  ie. patient is physically able to lift a kettle up and pour, but signals from the brain are interrupted/missing before they reach the muscle. Praxis is the ability to plan and perform purposeful movements.

Apraxia generally refers to loss of correct voluntary movement sequence acquired after stroke or brain injury, and dyspraxia generally refers to this when it is present from childhood as a developmental disorder.

Apraxia can be

  • ideational– patient does not have the concept in their mind of the action sequence that needs to occur in order to carry out a task. They don’t cognitively understand that they would rub a toothbrush on their teeth in order to clean them.
    • use an item inappropriately such as try to use a toothbrush like a pen, or use a tool in the wrong plane.
  • ideomotor– patient has the concept in their mind of the action sequence that needs to be done, but making the muscles respond to carry these out is not possible. They still know how to brush their teeth in their mind, but cannot access the ‘motor plan’ so struggle to use the tool and their limbs to do it;
    • they may use their finger instead of the toothbrush on their teeth
    • verbally repeat what needs to be done rather than physically carry it out
    • try to use their whole body as the action (eg rocking back and forth rather than just moving hand back and forth to use toothbrush)
    • can’t mime an action when verbally asked to “show me how you’d hammer a nail”
    • aren’t able to initiate movements but if the movement is prompted this may be enough for them to continue the action themselves, likewise automatic reactions that don’t require thought such as picking up a phone as soon as it rings, may still be possible. If they wanted to pick up the receiver and make a call however, they cannot initiate this action even though they know what they have to do.

Ataxia (Ph) (a=lack of;  taxia= order; need to keep your taxes in order!)

A lack of coordination of voluntary muscle movements.

Hemiparesis (Ph) (hemi=half; paresis= paralysis or weakness)

A weakness in the movements of one half of the body. The most severe form of hemiparesis is hemiplegia, which is total paralysis of one side

Speech

Aphasia or Dyspasia (M)

Unable to produce speech or understand spoken language, or unable to write language or read written words.

Verbal ataxia (Ph) (a=lack of;  taxia= order; need to keep your taxes in order!)

Unable to coordinate mouth muscle movements to produce speech, on its own does not affect ability to understand or produce language. Patient will struggle to sequence sounds for words, be aware of the errors they are making- subconscious or automatic spoken words will be more fluent that deliberate voluntary ones.

Dysarthria (Ph) (dys=lack of;  arthria= articulation; the word would be difficult for someone with slurred speech to say!)

Slurred speech caused  by inability to coordinate muscles of the mouth properly

Dysphagia or Aphagia (Ph)  (a/dys=lack of; phagia= eating; the G sounds like a Gulp swallowing)

Sensation

The ability to receive input from your five senses

Agnosia (M)

The sensations are recieved by the brain ok, but the brain cannot process them properly. Agnosia can effect any of the senses eg auditory agnosia, tactile agnosia, visual agnosia, smell agnosia or taste agnosia. This means the person may not be able to recognise objects by touch (shape, texture, weight), or objects by sight, or different sounds, etc. This can also lead to body agnosia, where the person’s senses tell them there is an arm touching their leg, but they are not able to process that it is their own and so they think it is somone else next to them.

Perception

The ability to process input from your five senses.

Cognition

Executive Dysfunction (M)

Unable to plan or problem solve in novel situations, the patient may lack insight into errors and achievable goals.

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