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Understanding Thalamic Stroke: Effects, Treatment, and Recovery

everything you need to know about thalamic stroke recovery

A stroke in the thalamus can have unique effects for every survivor. To understand how a thalamic stroke affects the body, it helps to look at what a stroke is and what functions the thalamus controls. This article will explain just that, along with an overview of the recovery process.

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Understanding a Stroke in the Thalamus

A stroke occurs when the supply of blood in the brain is compromised. This can happen when an artery becomes clogged by a blood clot (known as an ischemic stroke) or when a blood vessel bursts (known as a hemorrhagic stroke).

When a stroke affects the thalamus, it is because an artery in this area deep within the brain has been affected. Thalamic strokes fall under the category of subcortical strokes, which affect the deep subcortical brain regions, as opposed to the outer cortical region.

When a stroke occurs, it is a medical emergency as brain cells begin to die within minutes of losing blood supply. Blood flow needs to be restored as soon as possible to save the person’s life.

Stroke patients that receive swift, fast treatment usually experience less secondary effects and disability than those who receive slow treatment.

After a stroke has been treated, rehabilitation begins to address any secondary effects that have occurred.

Secondary Effects of a Thalamic Stroke

Each area of the brain controls different functions. Depending on where a stroke occurs, it can impair a variety of different bodily functions. For thalamic stroke survivors, we can look at the role of the thalamus for insight into the secondary effects that may occur.

The thalamus plays a role in our memory, emotions, sleep-wake cycle, executive functions, sensation, and sensorimotor control. When a stroke affects the thalamus, it can impair some of these functions — especially sensation.

The thalamus is responsible for relaying 98% of all sensory input within the body. Therefore, issues with sensation after a thalamic stroke are common.

Some secondary effects of a thalamic stroke include:

  • Impaired sensation such as numbness or tingling
  • Thalamic pain, also known as central post-stroke pain
  • Sleep disturbances
  • Memory loss
  • Changes in attention span
  • Speech difficulties (aphasia)
  • Hemispatial neglect (commonly left neglect)
  • Vision impairments
  • Difficulties with balance

Thalamic pain is a chronic condition that can have delayed onset. Sometimes it can take months or even years after a thalamic stroke for pain to develop.

It may start off as impaired sensation and later progress into thermal dysregulation such as freezing or scalding sensations. Over time, it can continue to progress to severe, chronic pain.

This makes it essential to communicate with your medical team if you are concerned about changes in your health and wellbeing after a stroke.

The Recovery Process After a Thalamic Stroke

Recovery from thalamic stroke revolves around restoring the abilities that were compromised by the stroke. Not all secondary effects can be restored or fully restored, but the intensity of rehabilitation has a meaningful impact on how much function a person can recover.

Here are some steps that survivors may take during the stroke recovery process:

1. Physical and Occupational Therapy

physical therapist showing thalamic stroke survivor arm exercises

When a thalamic stroke leads to motor impairments, physical therapy can help restore movement in the body. Occupational therapy also helps patients regain mobility, particularly with the activities of daily living such as eating.

The benefits of therapy occur through repetitive experience and practice. The brain attempts to become efficient by creating and strengthening neural pathways for tasks that are frequently experienced — a phenomenon is known as neuroplasticity.

2. Home therapy

It’s likely that insurance will cover some PT and OT after stroke. Once insurance stops covering visits to your therapist, it’s critical to keep exercising at home.

One way to keep up your motivation for home therapy is by investing in tools like Flint Rehab’s FitMi home therapy. The interactive home exercise device helps you achieve the repetitions necessary to rewire the brain and improve movement after stroke.

3. Sensory Reeducation

person feeling a soft towel for sensory reeducation

After a thalamic stroke, it’s common for survivors to experience sensory issues such as numbness, tingling, pins-and-needles sensations, or pain.

Sometimes the brain can adapt and regain the ability to process sensory information through a therapy called sensory reeducation. It involves practicing various exercises that involve sensation to encourage the brain to adapt and improve its ability to interpret sensation.

For example, you can alternate placing hot and cold towels on your arm to stimulate the brain’s sensory processing. Be sure to have a caregiver check that the towel isn’t too hot before placing it on your affected arm.

The key is to do these exercises regularly to give the brain enough consistent stimulation to spark neuroplasticity.

5. Vision Therapy

When vision impairments occur after thalamic stroke, patients can participate in vision rehabilitation therapy. Vision therapy often involves various eye exercises to retrain the brain how to control the eye muscles. Not all patients respond to this therapy, but some are able to achieve partial or full vision recovery.

6. Speech and Cognitive Therapy

speech therapist showing a young stroke survivor how to do voice exercises

Some potential secondary effects of a thalamic stroke include speech difficulties and changes in executive function such as memory loss or changes in attention span. A Speech-Language Pathologist is the best expert to seek help from.

An SLP knows how to diagnose and treat speech and cognitive issues in people with neurological injuries like stroke. It often works best to start therapy with an SLP and continue therapy at home with the guidance of your therapist.

Two SLPs actually created an app that patients can use at home called the CT Speech & Cognitive Therapy App. Your SLP can assign exercises for you to practice at home, or the app can provide an assessment and recommend exercises based on your ability level.

7. Pain Management

If you struggle with central post-stroke pain, then seeking treatment is critical. Some patients may find partial relief through medication. When nonsurgical pain treatment options fail to provide relief, talk to your doctor about surgical options such as a permanent spinal cord simulator implant.

It’s crucial to both seek social support and medical treatment to minimize depression and other potential psychological effects of living with chronic pain.

Recovery Time After Thalamic Stroke

Recovery time after stroke varies from person to person. This is because every stroke is different and every recovery will be different.

While it’s impossible to predict recovery time for any single person, it’s worth mentioning again that the intensity of rehabilitation has a significant impact on recovery.

When patients stick with a consistent rehabilitation program after discharge from inpatient therapy, they see better results than individuals that stop pursuing rehab. This is why a motivating home therapy program is often essential for recovery.

Whether it has been months or years since experiencing a stroke, rehabilitation is worth pursuing. When you put in the work, the brain will respond.

Recovering from a Stroke in the Thalamus

Recovery from a thalamic stroke will involve hard work and dedication from the survivor.

During the early stages of stroke recovery, your medical team will assess your condition and any secondary effects that were sustained, such as changes in sensation or balance. Then, you will work with a team of therapists to address these issues.

Your results will partially depend upon the consistency of your rehabilitation program. Find something that motivates you and try your best to stick with it.

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Get Inspired with This Stroke Survivor Story

5 stars

Mom gets better every day!

When my 84-year-old Mom had a stoke on May 2, the right side of her body was rendered useless. In the past six months, she has been blessed with a supportive medical team, therapy team, and family team that has worked together to gain remarkable results.

While she still struggles with her right side, she can walk (with assistance) and is beginning to get her right arm and hand more functional. We invested in the FitMi + MusicGlove + Tablet bundle for her at the beginning of August.

She lights up when we bring it out and enjoys using it for about 20 to 30 minutes at a time. While she still doesn’t have enough strength to perform some of the exercises, she rocks the ones she can do!

Thanks for creating such powerful tools to help those of us caring for stroke patients. What you do really matters!

David M. Holt’s review of FitMi home therapy, 11/09/2020

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