Symptoms of Central Nervous System Damage, for Example After a Stroke.
Mariusz Dębski
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Damage to the central nervous system (CNS) most often results from a stroke, inflammation of brain structures, tumours or traumatic brain injury; it can also be part of multiple sclerosis or Parkinson’s disease.
Each cerebral hemisphere oversees and controls the activity of the opposite side of the body. Damage to one side of the brain leads to impairment on the opposite side of the body — the left side of the brain affects the right side of the body and vice versa. We explain this relationship in more detail in our article on the brain areas and effects of brain damage after a stroke. Damage to the central nervous system causes disruption throughout the entire body, which is associated with a significant loss of independence due to motor and sensory symptoms.
Depending on which part of the CNS has been damaged, various abnormalities can be observed in the muscular system. These may include gait and balance disorders, hypotonia, hypertonia, paralysis or paresis affecting the hand and upper limb, muscle wasting, exaggerated reflexes, sensory disturbances and spasticity.
1. Altered excitability threshold of the muscular system
Excitability is the ability to respond to stimuli. As a result of brain damage, there may be a loss of skin sensitivity or of the sense of touch on the affected side. In people with left-sided hemiplegia, disturbances in body image may appear, along with an inability to perceive a limb and to locate it in space, as well as an inability to recognise the connection between the limb and the rest of the body.
- A disturbed body image and difficulty determining the position of a limb.
- An inability to plan movements and to carry out simple tasks in the correct order, such as making a cup of tea.
- An inability to handle objects.
- Difficulty maintaining a correct posture, for example leaning to one side.
- Difficulty telling right from left.
- Difficulty moving in a particular direction.
- An inability to recognise objects held in the hand with the eyes closed.
2. Spasticity
Spasticity is one form of increased muscle tone. It is characterised by a rise in muscle tone that depends on how quickly the muscle is stretched. It usually accompanies paresis, which further worsens the dysfunction of the limb. Excessive tone makes free movement impossible.
Without systematic, correctly conducted rehabilitation — ideally as part of neurological rehabilitation programmes — the limb can settle into an abnormal, permanent position, leading to muscle shortening, joint stiffness and the formation of contractures.
3. Rigidity
Rigidity is increased muscle tone that persists throughout the entire range of a movement. It is often described as a symptom characteristic of, among other conditions, Parkinson’s disease. In practice, it means a further loss of freedom of movement and a deterioration in the function of the limb.
Sources
- Assiociazione Italiana, A. Follereau, Usprawnianie po udarze, ELIPSA-JAIM s.c., Kraków 2004, p. 18.
- P. Laidler, Rehabilitacja po udarze mózgu, pp. 71–72, 233–234.
- Assiociazione Italiana. Amici di Raoul Follereau, Usprawnianie po udarze mózgu, ELIPSA-JAIM s.c., Kraków 2004, p. 155.
- I. Assiociazione, Usprawnianie po udarze, pp. 156–157.
- T. Kmieć, Spastyczność – leczenie farmakologiczne, Opieka Paliatywna nad dziećmi, 2008, Vol. XVI, p. 135.
- W. Dega, K. Malinowska, Rehabilitacja medyczna, Warszawa 1994, p. 440.
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