3. Practical advice and tips for carers > Physical deficits

Physical deficits

1) Sensation

After a stroke the person’s sensation can be affected. We have nerves from the spinal cord to parts of the body and the central nerves from the brain to the body. Our sensation pathways from the brain to areas of the body are complicated and sensory problems can be different from one person than another. Without sensation a person’s movements lack precision and control. Not every one who has a stroke will have problems with sensation and those who do will not have all of the following problems.

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Which of these possible problems are true or false after a stroke:

  • Loss or reduced touch. True This can be for light or deep touch sensation.
  • Loss or reduced temperature sensation True Can be for hot and cold. This can be a risk for scalding in the bath, shower or at the sink. If the person is sitting too close to a fire or radiator they may not know when the skin is being damaged. In the kitchen they may not feel when a surface or an appliance is hot, resulting in a burn.
  • Hypersensitivity to sensation. True The person may be over sensitive to pain just by light touch or when moving. The clothing they wear can feel uncomfortable or even painful next to the skin.
  • Loss of sensation from the bladder or bowel. True This may lead to incontinence problems but it may be possible to retrain the person with a regular toileting plan.
  • Paresthesia ( Altered sensation)- True This is an altered sensation such as tingling, numbness, aching, burning or “pins and needles”.
  • Proprioception (knowing where your body is)- True This is the loss or reduced ability to know where a body part is in the space around you and its position and orientation during movement. For example the person may not know when their foot is flat on the floor or turned at the ankle joint. This would then make walking more difficult even if the movements of the muscles are intact. They may grasp an object without realising it is still in their hand.
  • Central post stroke pain- True This can be difficult to treat as it may not be relieved by over the counter pain medicine. It is caused by damage to an area deep within the brain. It can be treated with combination of medicines and treatments including Amitriptyline to reduce the symptoms. However with this type of pain the condition is often managed rather than cured. Sometimes the person may be referred to a specialist pain management clinic.
  • Ticklishness - False This is not related to having a stroke.
  • Skin turns white when cold or emotionalFalse This is a condition called Raynaud's and is not stroke related.
  • Buzzing in the ear False Usually this is called tinnitus and is not caused by stroke.

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Which of these possible problems are true or false after a stroke:

  • Loss or reduced touch. True This can be for light or deep touch sensation.
  • Loss or reduced temperature sensation True Can be for hot and cold. This can be a risk for scalding in the bath, shower or at the sink. If the person is sitting too close to a fire or radiator they may not know when the skin is being damaged. In the kitchen they may not feel when a surface or an appliance is hot, resulting in a burn.
  • Hypersensitivity to sensation. True The person may be over sensitive to pain just by light touch or when moving. The clothing they wear can feel uncomfortable or even painful next to the skin.
  • Loss of sensation from the bladder or bowel. True This may lead to incontinence problems but it may be possible to retrain the person with a regular toileting plan.
  • Paresthesia ( Altered sensation)– True This is an altered sensation such as tingling, numbness, aching, burning or “pins and needles”.
  • Proprioception (knowing where your body is)– True This is the loss or reduced ability to know where a body part is in the space around you and its position and orientation during movement. For example the person may not know when their foot is flat on the floor or turned at the ankle joint. This would then make walking more difficult even if the movements of the muscles are intact. They may grasp an object without realising it is still in their hand.
  • Central post stroke pain– True This can be difficult to treat as it may not be relieved by over the counter pain medicine. It is caused by damage to an area deep within the brain. It can be treated with combination of medicines and treatments including Amitriptyline to reduce the symptoms. However with this type of pain the condition is often managed rather than cured. Sometimes the person may be referred to a specialist pain management clinic.
  • Ticklishness – False This is not related to having a stroke.
  • Skin turns white when cold or emotional False This is a condition called Raynaud’s and is not stroke related.
  • Buzzing in the ear False Usually this is called tinnitus and is not caused by stroke.