Progressive Motor Deficits and Psychosis After Stroke: A Case Presentation.

Abstract

N eurological deficits after a stroke are extremely common. Most patents experience dysarthria, aphasia, facial weakness, and weakness of upper and lower limbs after a stroke (Yanagida, Fujimoto, Inoue, & Suzuki, 2015). Facial hemiparesis, motor weakness of arms, and slurred or strange speech are associated as warning signs of stroke and signal the patient that urgent treatment is needed (National Heart, Lung, and Blood Institute, 2014). Fast treatment allows for quicker reperfusion of the brain tissue, limiting the amount of damage to the brain and the severity of the deficits experienced by the patient. The onset of neurological deficits from stroke is often several minutes after blockage or hemorrhage; however, deficits can continue to develop for up to several days after infarct (National Heart, Lung, and Blood Institute, 2014). Delayed motor deficits or progressive motor deficits (PMD) that develop several years after stroke are relatively rare in the literature. One notable case study discusses delayed neurological deterioration including worsening of dysarthria and ataxia several months after pontine hemorrhage (Menezes Cordeiro, Tavares,Reim,o, Geraldes, & Ferro, 2013). This progression was attributed to an increase in the area of hypertrophy in the pontine region, confirmedwithmagnetic resonance imaging (MRI) comparison (Menezes Cordeiro et al., 2013). However, research has shown that it is common for survivors of stroke to experience mental health disorders such as depression and anxiety; in fact, up to a third of survivors are eventually diagnosed with such disorders (Hackett, Yapa, Parag, & Anderson, 2005). Other mental health disorders such as delusions and hallucinations are not well documented in the literature. The purpose of this article is to gain a better understanding of delayed motor and psychological disorders in a stroke survivor.