S4 Long term stroke management

Question 1

What is the physiological basis of recovery from stroke? (2,2)

Answer 1

Natural recovery: resolution of oedema, reperfusion of ischaemic penumbra.
Neuronal plasticity and cortical remodelling.

Question 2

What is neglect? Which stroke does it occur in?

Answer 2

Only in right parietal lobe stroke.

Failure to attend to left side. Visual or somatosensory.

Question 3

What is agnosia?

Answer 3

Modality specific inability to access semantic knowledge of an object (or other stimulus).

E.g. can’t recognise an object by sight, but can by touch

Question 4

What is prosopagnosia?

Answer 4

Inability to recognise faces.

Question 5

What is dyspraxia?

Answer 5

Loss of ability to conceptualise, plan or execute complex motor actions.

Question 6

Where do dyspraxia causing lesions occur? (2)

Answer 6

Left inferior parietal lobe.

Supplementary motor area.

Question 7

What is a spastic hemiparetic gait? (3)

Answer 7

Stiff legged (spasticity of flexor muscles).
Short, slow steps.
Risk of falls (unable to dorsiflex, loss of righting reflex).

Question 8

What is spasticity and what are the consequences? (3)

Answer 8

Hyper excitability of the stretch reflex.

Loss of function, unable to maintain skin hygiene, pain.

Question 9

What are the treatments for spasticity? (3)

Answer 9

Physiotherapy and splinting.
Local botulinum toxin injections.
Baclofen (systemic).