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The Effects of Stroke on Pain, Incontinence, and Language

Stroke survivors frequently have a variety of chronic pain syndromes resulting from stroke-induced damage to the nervous system (neuropathic pain). People who have a seriously weakened or paralyzed arm resulting from a stroke commonly experience moderate to severe pain that radiates outward from the shoulder. In most cases, the pain will result from a joint becoming immobilized due to lack of movement and the tendons and ligaments around the joint will become fixed in one position. This is commonly called a "frozen" joint. Passive movement at the joint in a paralyzed limb is essential to prevent painful "freezing" and to allow easy movement if and when voluntary motor strength returns.
Some patients experience damage to the pathways for sensation in the brain, causing false signals to be transmitted that result in the sensation of pain in a limb or side of the body that has the sensory deficit. The most common of these pain syndromes is called "thalamic pain syndrome," which can be difficult to treat even with medications.
It is fairly common for stroke survivors to become incontinent immediately after a stroke. This incontinence often results from a combination of sensory and motor deficits. Stroke survivors may lose the ability to sense the need to urinate or the ability to control muscles of the bladder. Some may lack enough mobility to reach a toilet in time. Stroke survivors may also experience loss of bowel control or constipation. Although permanent incontinence after a stroke is uncommon, even a temporary loss of bowel or bladder control can be emotionally difficult for stroke survivors.

Effects on Language

At least one-fourth of all stroke survivors experience language impairments, involving the ability to speak, write, and understand spoken and written language. A stroke-induced injury to any of the brain's language-control centers can severely impair verbal communication.
Stroke survivors may experience aphasia, a neurological disorder caused by damage to the portions of the brain that are responsible for language.
There are four general categories of aphasia:
  • Expressive aphasia
  • Receptive aphasia
  • Global aphasia
  • Anomic or amnesic aphasia.
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