After a stroke, patients can experience a wide range of symptoms depending on where the stroke occurred in the brain and how severe it was.
Patients who experience facial paralysis and speech impairment after a stroke typically need ongoing speech therapy. At Memorial Regional Hospital, Speech Language Pathologist Joan Parnell works with doctors and patients to develop specialized treatment plans. The treatment begins by understanding the area in the brain where the stroke has occurred.
“Every patient is different, so it varies patient to patient,” Parnell said. “Their age, prior level of function, severity of CVA (cerebrovascular accident), and a patient’s motivation all have an affect on how the treatment is provided and the outcome of treatment.”
A stroke happens when blood flow to an area of the brain is cut off. Brain cells are then deprived of oxygen and begin to die.
“When brain cells die during a stroke, abilities controlled by that area of the brain, such as memory and muscle control, are lost,” according to the National Stroke Association.
When a stroke happens in the left side of the brain, the right side of the body is affected, and when a stroke happens in the right side of the brain, the left side of the body is affected.
The left side of the brain involves speech and language. The left frontal lobe, or Broca’s area, involves speech production. Impairment here usually means the patient can’t form words properly and has slurred or slow speech but can typically understand, she said. The left temporal lobe, or Wernicke’s area, is responsible for comprehension of language.
“When someone has facial paralysis, typically, a speech therapist would have the patient do exaggerated lip, face, tongue exercises, such as smiling, puckering of lips, protruding, lateralizing, and elevating tongue,” Parnell said. “The patient’s prior level of health, severity of CVA/TBI, and motivation/diligence of performing treatment tasks will affect outcomes. Speech therapy is just like any other task — if you don’t practice outside of the treatment room, then typically, your progress is not as great as someone who does.”
Following any brain injury, some patients may experience depression and feel their intelligence has been taken away, Parnell said.
“I typically educate them that they haven’t lost their intelligence, but that a storm has come through their brain and damaged some of the lines/wires, like electrical and phone wires would be damaged in a bad storm,” she said. “They then need to perform therapy to improve the damaged wires of their brain. They may not only feel ‘dumb’ — as they often say to me — or they are embarrassed, so I celebrate the smallest successes to improve their confidence and keep building from there.”
Because these patients have experienced this storm within their brains, it’s important for friends, family and other caregivers to be patient. Parnell suggests keeping commands and directions simple, allowing the person plenty of time to communicate and not answering questions for them.
“Continue to treat them as a loved one, not as a patient.”
For more information about stroke treatment at Memorial Regional Health, visit memorialregionalhealth.com.