Post stroke symptoms
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Summary
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These studies suggest that post-stroke symptoms commonly include mental health issues, fatigue, and central post-stroke pain, with various factors influencing these symptoms and potential treatments involving both physical and psychological interventions.
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Post-Stroke Symptoms: An Overview
Mental Health Symptoms: Depression, Anxiety, and Stress
Post-stroke individuals often experience significant mental health challenges, including depression, anxiety, and stress. A study focusing on Jordanian stroke survivors found that 74.5% experienced depression, 52.9% had anxiety, and 68% reported stress symptoms. Key predictors of these mental health issues included lower scores on the SF-12 Mental Composite Score and reduced grip strength. Additionally, discontinuation of rehabilitation services was significantly associated with increased depression and stress, while fewer sleep hours were linked to higher anxiety and stress levels.
Post-Stroke Fatigue (PSF)
Prevalence and Impact
Post-stroke fatigue (PSF) is a prevalent and debilitating symptom that affects a significant portion of stroke survivors. The prevalence of PSF varies widely, with estimates ranging from 29% to 70% depending on the measurement tools and patient characteristics . A systematic review and meta-analysis reported that the pooled prevalence of PSF was 49.5% at 1 to 6 weeks, 41.9% at 3 months, and 43.4% at 6 months post-stroke. PSF has a substantial negative impact on activities of daily living (ADLs) and health-related quality of life (HRQoL) .
Risk Factors and Management
The risk factors for PSF are multifactorial, including biological, physical, and psychological elements. Inflammation is suggested to play a key role in the development of PSF. Despite its prevalence, effective management strategies for PSF are limited. Evidence suggests that a combination of physical and psychological interventions may be beneficial, although single-disciplinary approaches are often unsuccessful . Advanced imaging techniques and further research are needed to better understand the etiology and develop targeted treatments for PSF.
Central Post-Stroke Pain (CPSP)
Characteristics and Prevalence
Central post-stroke pain (CPSP) is another common and debilitating symptom. It is characterized by various types of pain, including burning, aching, pricking, and lacerating sensations. The pain often intensifies with external stimuli such as joint movements, cold, and light touch. CPSP is associated with lesions in the spino-thalamo-cortical pathway, which is crucial for temperature and pain sensibility.
Neurophysiological Insights
The physiopathology of CPSP is not well understood, which hampers the development of effective diagnostic and therapeutic strategies. Studies using transcranial magnetic stimulation (TMS) have shown cortical neurophysiological changes in CPSP patients, but the results are heterogeneous and inconclusive. Further research is needed to integrate these neurophysiological measures with clinical symptoms to improve diagnosis and treatment.
Conclusion
Post-stroke symptoms such as mental health issues, fatigue, and pain significantly impact the quality of life and recovery of stroke survivors. While the prevalence of these symptoms is high, effective management strategies are still under development. Future research should focus on understanding the underlying mechanisms and developing targeted interventions to improve the overall well-being of stroke survivors.
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