As a result of a stroke, blood circulation in the brain is disrupted. It is accompanied by damage to the central nervous system with subsequent complications of brain function.
In most cases, a person experiences speech impairment due to a cerebral stroke and has difficulty pronouncing or understanding it.
This turns out to be a big psychological problem for the patient and his loved ones. With the correct treatment method, the rehabilitation period is faster and more effective.
When do they talk about a “silent stroke”?
Naturally, many people have questions about what condition can be called a “silent stroke.” After all, almost everyone knows about the symptoms of the usual - social advertising, doctors and even social networks talk about them.
“A “silent” (or “silent”) stroke is an acute disorder of cerebral circulation, which does not entail pronounced clinical symptoms and is most often diagnosed retrospectively using computed tomography or magnetic resonance imaging of the brain,” notes Aminat Dolova.
And the young ones too? Debunking myths about micro-strokes Read more
Signs of a problem
Doctors advise listening to yourself in order to recognize the signs of an impending problem in time. As the neurologist notes, it is not always the case that such a stroke is completely asymptomatic. So, notes Aminat Dolova, it may be indicated by such signs as:
- sudden dizziness;
- problems with gait disturbance;
- visual impairment;
- development of strabismus;
- loss of speech clarity;
- the onset of facial asymmetry;
- a feeling of numbness, as well as a feeling of weakness in the limbs.
“If the symptoms are transient, patients often do not seek medical help and forget about the problem, but small areas of damage still form in the brain, which can later be seen on a CT or MRI,” notes Aminat Dolova
The specialist emphasizes that it is necessary to consult a doctor if such signs are detected. “Based on the complaints, the doctor will conduct an appropriate examination, which will confirm or refute the diagnosis,” says Aminat Dolova.
Close to heart. Academician Alekyan on how heart attack and stroke are treated today Read more
How to treat aphasia
As everyone is taught from childhood, “nerve cells do not regenerate.” In fact, this is not entirely true: even in very old people, new connections can be formed between living neurons - “bridges” along which information will flow from the nerve cell on one side from the source of the stroke to the neuron on the other side. But for this you need:
- daily activities that will use areas of the brain located next to the dead zone;
- sufficient blood supply to the brain, especially in the affected area;
- providing the brain with the necessary amount of oxygen;
- elimination of additional chaotic impulses that arise in the brain during stress and prevent the flow of impulses from being directed to the area near the site of dead cells. Stress in aphasia is caused by the fact that a person understands his inability to convey his thoughts to others.
Aphasia after a stroke is also treated according to these principles. It needs to be started as early as possible - as soon as the swelling of the brain is stopped, which is manifested by depression of consciousness (from drowsiness to coma), convulsions, and hallucinations.
Therapy should be:
- started as early as possible;
- carried out daily, to the extent that the patient can handle;
- is aimed at correcting not only oral, but also written speech, if such a syndrome occurs in your relative.
In some cases, aphasia after a stroke can resolve on its own, but this is extremely rare, so you should not count on such an outcome. Basically, treatment of this syndrome is a long and painstaking process, requiring great dedication from relatives.
Let's look at each type of therapy in detail.
It is prescribed by a neurologist at the hospital where the stroke patient is located, and begins as early as possible. Drug therapy includes drugs that improve the delivery of oxygen and nutrients to the brain, strengthen nerve connections in it, and optimize metabolism in it. This:
- "Cerebrolysin" ("Semax");
- "Gliatilin" ("Holitilin", "Cereton");
- "Somazina" ("Ceraxon");
- succinic acid preparations “Cytoflavin”, “Reamberin”, “Mexidol”;
- B-group vitamins: Neuromidin, Milgamma.
These drugs are used in combination, according to the scheme that is practiced by this medical institution. Initially, they are administered intravenously and intramuscularly for 1-3 weeks. Next, they switch to the tablet form of these medications.
In addition to these medications, the patient is administered those medications that his condition requires. Therefore, if aphasia after a stroke is complemented by other, more life-threatening disorders, the complex of treatment for the speech disorder itself is “cut down” - to reduce the drug load on the internal organs.
Physiotherapy
To treat aphasia after a stroke, physiotherapeutic procedures are performed to improve cerebral circulation. This:
- acupuncture;
- electromyostimulation (exposure to current pulses) of the muscles involved in articulation;
- exposure of the cerebral cortex to a magnetic field.
Classes with a speech therapist
A special speech therapist, an aphasiologist, deals with the relief of aphasia after a stroke. Typically, these specialists work in the same medical institution that treats stroke, but in some cases, relatives have to find such a specialist on their own.
Classes with an aphasiologist should begin in the neurological department, a week after the patient is transferred from the intensive care ward. This doctor trains an older person who has had a stroke for 5-7 minutes at first, gradually increasing the training time to 15 minutes. It works like this:
- Build a dialogue with the patient.
- Seek understanding.
- Practice reading.
- Recall writing skills.
Before starting classes with a patient with sensory aphasia, if he does not understand his condition, he is asked to write a word (usually he writes a set of letters), then read it. They communicate with him through facial expressions and gestures. On a piece of paper with a set of letters, underline with a pencil or pen.
The aphasiologist must show the relatives the exercises he performs with the patient so that they can repeat them in the evening.
Examples of exercises:
- Bloating of the cheeks.
- Licking the tongue alternately between the upper and lower lips.
- Stretching your lips with a tube, after which you need to hold them in this position for 5 seconds, then relax.
- Tongue movements: to the tip of the nose - to the chin.
- Attempts to form a tube in front of a mirror.
- Move the lower jaw forward and upward to grab the upper lip with your teeth. Then do the same with the lower jaw.
- With your mouth closed, you need to try to reach the tongue with your tongue.
- Clicking the tongue against the roof of the mouth.
- Image of kisses.
- Pronunciation of simple familiar words.
With an aphasiologist, they learn a phrase or word with which to start communication, “remember” counting from 1 to 10 and in reverse order.
Melodic intonation therapy is effective in the treatment of aphasia: while singing, articulation improves and self-confidence appears. They begin singing with a familiar song, supporting the patient in every possible way, even if he could not utter a single intelligible sound.
For sensory aphasia, training with cards with pictures on them helps. You can use special computer programs (for example, a program for speech therapists by Ryabtsun) or applications on your phone. The aphasiologist asks the patient to explain what he wants to say using pictures. Also, if a person confuses letters in words, he asks to show where, for example, “barrel” is depicted and where “kidney” is depicted.
If speech is slightly affected, or at later stages of treatment, they resort to dictations and reading aloud. For treatment, it is also important to pronounce tongue twisters, especially those sounds that the patient cannot pronounce.
After each successfully completed task, the patient is praised.
In addition to exercises and dictations, a speech therapist-aphasiologist performs speech therapy massage. To do this, he carefully massages different areas of the tongue, lips, cheeks, and palate using a spatula or spoon. The purpose of the massage is to restore muscle tone in these areas in order to improve speech.
Patients with aphasia after a stroke, especially its motor variety (when they understand speech, but cannot reproduce it), are distinguished by tearfulness and depressed mood. To prevent them from developing depression, they need sessions with a psychotherapist. This specialist will assess the mental state of your relative and, based on this, prescribe the appropriate type of psychotherapy, which can be supplemented with the necessary medication support.
In most cases, the psychotherapist conducts classes not only with the patient himself, but also with his relatives. He explains how they need to build a line of behavior towards the patient, how to communicate with him, how to react to his tears or attacks of anger.
At the moment, for the treatment of severe forms of aphasia that are not amenable to standard therapy, the following can be used:
- Introducing stem cells into the blood - those human cells that can turn into any other cells in the body. It is assumed that stem cells, sensing “signals” from the stroke-damaged brain, are sent there and replace (at least partially) the dead areas of nervous tissue. As a result, the volume of dead brain tissue decreases, and further sessions with a speech therapist have a better chance of restoring speech.
- An operation called extra-intracranial anastomosis. It consists of creating an artificial connection between an artery lying outside the cranial cavity (temporal artery) and the middle cerebral artery, which supplies the brain. The operation has not yet received widespread use and is aimed at improving blood supply to the brain.
After discharge, relatives will need to continue the therapy started in the hospital:
- taking medications in tablets;
- exercises for the speech apparatus: prescribed by a doctor or those listed above;
- speaking tongue twisters;
- if necessary, sessions with a psychologist and psychotherapist.
You need to treat the patient politely, try not to focus on the fact that his speech is incomprehensible, repeat that this is a temporary difficulty and with joint efforts you will cope with this disease. Speak clearly, clearly, but not as loudly as with a mentally retarded or unintelligent baby. Try to touch only on topics that will inspire him with optimism.
Don't isolate an elderly relative. On the contrary, try to gather around him many relatives and friends who will communicate with him and among themselves, so that he can hear their speech. If the speech impairment is severe, then it is better to ask him questions in such a way that he can answer negatively or affirmatively.
The patient can watch programs and videos, but no more than 2 hours a day. This is explained by the fact that you cannot overload certain areas of the brain that has not yet fully recovered, so as not to cause a deterioration in the condition. The programs, films or videos you watch must be positive.
Risk group
Of course, many people are concerned about whether they can predict the possibility of developing such a problem in themselves. As Aminat Dolova notes, those at risk for developing the pathology of “silent stroke”:
- people suffering from hypertension;
- people with diabetes;
- those who have heart rhythm disturbances;
- people suffering from atherosclerosis of the carotid arteries.
There is also a certain set of risk factors that can lead to the development of a silent stroke. So, the following can provoke a problem:
- unbalanced unhealthy diet;
- sedentary lifestyle;
- the presence of obesity, especially if we are talking about the abdominal type.
So those who are at risk or have a potential danger, for example, the same sedentary type of work, which is also accompanied by eating fast food and not the most healthy snacks, as well as other provoking factors, should be more attentive to themselves and listen to signals more often the body and respond to them in a timely manner.
"It's very scary". Young stars who survived a stroke Read more
Speech restoration
Regardless of the forecasts and people’s opinions, the speech apparatus needs to be restored. Because thanks to this, a person can painlessly communicate in society with other people. But self-medication is not recommended, because you can only make things worse for yourself, worsen the situation.
How to restore speech after a stroke
The recovery program as a whole is drawn up by the attending physician, which includes a speech therapist. It is this medical worker who will be responsible for restoring the patient’s speech. Depending on the type of dysfunction of the speech apparatus, treatment will depend. This usually includes massage, exercises for the muscles that help you speak, medications, and other treatments.
Speech recovery speed
As has been written more than once above, the speed of speech recovery directly depends on the degree of brain damage and the characteristics of the patient’s body. Therefore, the time frame for recovery of the speech apparatus after a stroke is different for everyone: several months, a year, several years, or in the worst case, never. However, you should not give up, you must believe in the best. After all, many people regain speech in the first few months. It is only important to follow all the doctor’s recommendations.
What are the forecasts?
Many people are afraid of stroke because of its unpredictability. So, it can pass almost without a trace, or it can paralyze a person - both entirely and partially. Silent stroke also worries many people in terms of its prognosis. “The prognosis of the disease is usually favorable, however, according to research, 10-15% of patients who have suffered a silent stroke develop a more serious cerebrovascular accident over the next few years,” notes Aminat Dolova.
So, when making such a diagnosis, it is worth monitoring your condition and at the first signs of any disturbances, consult a doctor. This will save life and health.
Question answer
Is it possible to get rid of movement disorders after a stroke?
Types of violations
To undergo a successful recovery, the speech therapist must correctly determine the type of speech impairment after a stroke. Depending on this, the treatment and features of rehabilitation of the speech apparatus will depend. There are three types of disorders: aphasia, dysarthria and dyspraxia. Moreover, even speech therapists often confuse the last two with each other, and not only because of the similarity of names. But first things first, let’s look at each type of speech disorder after a stroke in turn.
Aphasia
The first type of speech dysfunction is called aphasia. This form of dysfunction of the speech apparatus is divided into several subtypes, depending on which part of the brain was affected during the stroke. It’s worth noting right away that there are four subtypes of aphasia, but some doctors distinguish more and this is not a mistake, since there are several classifications. Now let's look at the 4 types of aphasia briefly:
- motor (the posterior parts of the frontal bone are affected) - the patient repeats the same word, sound or syllable;
- articular (the lower parts of the parietal region are affected) – the patient is not able to choose the correct position of the lips or tongue, which is why words and phrases are pronounced incorrectly or not pronounced at all;
- sensory (the upper temporal region is affected) – the patient does not perceive sounds and does not understand speech, as a result of this the person unconsciously replaces sounds in his own words;
- acoustic-mnestic (the posterior and middle parts of the temporal region are affected) - the patient cannot remember all the words that he just heard, because of this he does not perceive long sentences, and as a result he makes mistakes in his own speech.
As can be seen from the list, the subtypes of aphasia directly depend on the part of the brain that was damaged during the stroke. Restoration of such consequences depends on the degree of damage and the speed of regeneration, which is individual for each person. Usually, a speech therapist gradually begins to train a person, but the rehabilitation process takes a long time, because the brain does not recover so quickly.
Dysarthria
This type of speech disorder is characterized by impaired mobility of the muscles of the human speech apparatus. Because of this, the patient’s speech is slurred or completely incomprehensible. This consequence of a stroke may be accompanied by disturbances in the process of swallowing and breathing, but by the time you start working with a speech therapist, these problems are eliminated by the attending physician or minimized. The following symptoms are characteristic of dysarthria:
- slurred or slurred speech;
- distortion of sounds;
- speech with hesitation;
- change in voice timbre;
- monotone;
- involuntary grimaces due to uncontrolled contraction of the facial muscles;
- slow/fast pace of speech.
But dysarthria can develop into anarthria - this is a situation when the speech and motor muscles are paralyzed and do not work completely. In this case, treatment lasts for years and does not often result in a positive outcome. In the case of dysarthria, the speech therapist prescribes special exercises and procedures to develop muscles, including massage.
Dyspraxia
Dyspraxia strongly resembles dysarthria, and, as mentioned above, not only by the similarity of names. Dyspraxia is a pathology of the speech apparatus, in which the movements and coordination of the muscles responsible for speech are impaired. As you can see, dyspraxia is very similar to dysarthria. But in the first case, the disease is not accompanied by paralysis of muscle tissue, while in the second this phenomenon is present to one degree or another.
Preventive actions
The situation with silent stroke is the same as with many other diseases - there are certain preventive measures that will prevent risks. “Prevention of silent strokes is no different from the prevention of clinically significant cerebrovascular accidents. According to research results, among risk factors, arterial hypertension is the most common and significant modifiable risk factor,” says Aminat Dolova.
Also, the specialist emphasizes, in addition to the control and treatment of hypertension, other points should be adjusted. For example:
- fight lipid metabolism disorders;
- monitor heart rhythm disorders and correct them under the supervision of a physician;
- stop smoking;
- exclude alcohol;
- start normalizing your weight;
- provide rational nutrition;
- devote time to sports, etc.
“Studies have shown that up to 80% of strokes can be prevented with preventive measures,” notes the neurologist. At the same time, the proposed measures are not complicated and are accessible to everyone. So there is no need to exclude them from your daily routine.
There are contraindications, you should consult your doctor
How to restore speech after a stroke
Studies conducted by scientists around the world have shown that it is possible to completely get rid of the consequences of a stroke only in the first 3 months after the stroke.
If 6 months to 2 years have passed since the onset of the disease, the patient’s condition can be improved. However, the rehabilitation process will be longer and more complex.
When treating speech-related consequences of a stroke, you need to pay special attention to sessions with a speech therapist. It is also useful to collaborate with other medical specialists whose work is aimed at speech restoration.
Training under the guidance of a speech therapist
In addition, for patients who have speech impairment associated with a stroke, sessions with a psychologist are indicated. Problems with speech negatively affect the psychological state of the patient.
Classes with a doctor contribute to the speedy restoration of speech
For dysarthria, therapeutic massage, physiotherapy and electrical stimulation are indicated.
It should be noted that the recovery process directly depends on the patient - the patient must be patient, believe in himself and hope for the best.
Traditional methods
During a stroke, the blood circulation process is disrupted, the white and gray matter, as well as the cerebral cortex, are damaged. It is these processes that can provoke speech impairment in patients, as well as other pathological symptoms.
Pine tea with lemon will speed up recovery
Not only drug therapy, but also traditional medicine advice can help restore speech functions after a stroke:
- Tea of their pine decoction and lemon. To prepare the medicine, you need to take 0.5 orange without peel and a decoction made from pine twigs (pour 30 grams of pine twigs into a liter of boiling water). Mix all the ingredients in a thermos and leave for about four hours. Drink a glass of decoction once a day.
- An infusion of the roots of decorative peonies helps restore brain function after a stroke. To prepare the medicine, just pour 30 ml of ethyl alcohol into two or three crushed peony roots. Leave for 7 days in a dark place. Take the medicine 3 times a day, fifteen to twenty drops.
- Birch tar in the form of a medicinal decoction will help cure the effects of ischemic stroke. It is recommended to prepare the medicine like ordinary tea. Drink a glass of decoction twice a day. Birch tar is an effective traditional medicine that thins the blood and prevents the formation of blood clots and cholesterol plaques.
- If facial expressions are impaired, medical experts recommend preparing a medicinal ointment from bay leaf powder. Any baby cream is suitable as a base for an ointment. To prepare the ointment, you need to take four to six laurel leaves, crush them with a tube of cream (80 ml). Before going to bed, rub the medicine into the facial muscles with massaging movements.
To treat the speech consequences of a stroke, traditional medicine advice should be used very carefully, since there is a possibility of an allergic reaction. Before starting therapy, you need to take the medicine in a minimum dose. If no side effects occur, therapy can be continued.
Proponents of traditional medicine advise people who have suffered a stroke to include nuts, dried fruits, viburnum and hawthorn berries in their daily diet. These medications contain vitamins and microelements necessary for the restoration of brain cells. A properly selected diet after a stroke is the key to a quick recovery after a stroke.
