Stroke and neurological support

What is a stroke?

• A stroke is caused by the interruption of blood supply to the brain, usually because a blood vessel is blocked by a clot (ischaemic – 85%) or bursts (haemorrhagic – 15%)
• Approximately 152,000 new strokes in the UK every year (more than one every five minutes)
• 1.4 million stroke survivors living in the UK
• 38,000 deaths caused by a stroke in the UK each year 
• Approximately one in four stroke survivors die within a year 

What is a transient ischaemic attack (TIA)?

• A TIA is also commonly known as a mini stroke 
• Stroke symptoms that last less than 24 hours 
• Fully resolves, but often precede a full stroke 
• This is a medical emergency and you should call 999

Is a stroke a long-term condition?

A stroke is (hopefully) a one-off event. However, most patients already live with a long-term health condition - diabetes, COPD, IHD, atrial fibrillation, hypertension, hyperlipidaemia or individuals can be left with a long-term problem as a result of a stroke. 

Risk factors 

Modifiable:

• high blood pressure
• heart disease 
• atrial fibrillation
• diabetes
• smoking
• alcohol 
• diet
• high cholesterol 
• cardiovascular / arterial disease 
• stress / depression 
• exercise 
• recreational drug use 
• economic deprivation

Non-modifiable:

• age
• sex
• ethnicity
• previous TIA or stroke 
• family history 

Impairments 

• Physical – upper and lower limb – mobility can be affected by problems with balance, weakness, stiff/tight muscles or a partial dislocation 
• Sensory changes including pain, numbness, pins and needles/abnormal sensations, hypersensitivity 
• Swallowing problems requiring modified diets/fluids or alternative feeding
• Emotional lability – having sudden, intense mood swings
• Cognitive – personality, behavioural changes, memory, attention, perception 
• Visual changes – loss of sight, visual inattention, hemianopia/quadrantanopia, acuity, double vision 
• Communication deficits – dysarthria, aphasia (receptive and/or expressive)
• Incontinence – bladder: retention, urgency, frequency, worsening of stress incontinence, bowels: incontinence, constipation
• Skin – pressure care, skin folds, friction and shear, hand and foot care 
• Fatigue 

Recovery 

• Symptoms nearly always improve to some degree, but everyone's recovery is different 
• The fastest improvement happens in the first few days, but recovery continues for weeks, months and years 
• Brain has to learn and develop new pathways 
• Psychosocial adjustment to long term changes 
• Affect on the family, friends and relationships 

For further information and support about stroke visit: Stroke Association | Strength through support

How we work with long-term neurological conditions 

A long-term condition is a health problem that lasts for a year or longer and requires ongoing management. These conditions cannot be cured but can be controlled with treatments like medication and therapies.

Managing long-term conditions often involves a combination of medication, lifestyle adjustments and other therapies to control symptoms and improve quality of life.

Individuals with long-term conditions can take an active role in managing their health through self-care practices, such as medication adherence, healthy eating and regular exercise. 

Multiple sclerosis

Multiple sclerosis (MS) is a condition that affects the brain and spinal cord, causing a range of symptoms including vision problems, numbness and balance issues. It's an autoimmune disease where the body's immune system mistakenly attacks the myelin sheath, the protective covering of nerve fibers, according to the National Institute of Neurological Disorders and Stroke. While there's no cure, treatments can help manage symptoms and slow progression. 

Find out more:

• National Multiple Sclerosis Society
• MS Society
• MS Trust

Functional Neurological Disorder (FND)

FND is a condition where there's a problem with how the brain and nervous system communicate, leading to neurological symptoms without any identifiable structural damage in the brain or nerves. Essentially, it's like the 'software' of the brain isn't working correctly, causing issues with movement, sensation, and other neurological functions. 

Find out more: 

• FND Hope International
• FND Action
• FND FrieNDs 

Huntington’s disease

Huntington's disease (HD) is an inherited disorder that causes nerve cells (neurons) in parts of the brain to gradually break down and die. The disease attacks areas of the brain that help to control voluntary (intentional) movement, as well as other areas.

Huntington's disease is an inherited condition that affects your movement, thinking and mood. It gets worse over time and cannot currently be cured, but there are treatments to help with the symptoms.

Find out more:

Huntington's Disease Association

Spinal conditions

Spinal conditions encompass a wide range of disorders and injuries affecting the spine, from the neck (cervical) to the lower back (lumbar). These conditions can result in pain, stiffness, numbness, tingling or even more serious issues like paralysis. Common examples include back pain, sciatica, spinal stenosis and various forms of arthritis and disc problems. 

Neuromuscular conditions

Neuromuscular conditions are a group of disorders that affect the nerves and muscles, leading to weakness, pain, and other symptoms. These conditions can stem from problems in the muscles themselves, the neuromuscular junction (where nerves and muscles connect), the nerves that supply the muscles, or even the spinal cord.

Neuromuscular conditions encompass a wide range of diseases and disorders that impact the nerves and muscles responsible for movement. The neuromuscular system is the connection between the nervous system and muscles, allowing for voluntary movement and sensory feedback. Problems in this system can lead to various symptoms, including muscle weakness, atrophy, pain, spasms, and difficulty with movement and co-ordination. 

Key aspects of neuromuscular conditions

• Muscle weakness: a hallmark symptom, often leading to difficulty with daily activities
• Muscle atrophy: muscle wasting due to nerve or muscle damage
• Pain: may be sharp, burning, or radiating, depending on the condition
• Spasms and twitching: involuntary muscle contractions or twitches
• Breathing problems: if the muscles involved in breathing are affected
• Swallowing difficulty: if throat muscles are affected
• Balance and co-ordination issues: due to nerve or muscle dysfunction

Find out more:

Muscular Dystrophy Association

Parkinson’s plus syndromes

Parkinson's plus syndromes are a group of neurodegenerative diseases that share some features with Parkinson's disease (PD), but also have additional symptoms and characteristics that differentiate them. These conditions, also known as atypical parkinsonism, can be difficult to diagnose and can have a wide range of clinical presentations. 

Key features of Parkinson's plus syndromes:

• Shared symptoms with PD: tremor, rigidity, akinesia (slowed movement), and postural instability, which are also seen in PD. 
• Additional features: these conditions may also present with dementia, cognitive deficits, cranial nerve impairment, visual hallucinations, and other non-motor symptoms. 
• Poor response to levodopa: unlike PD, Parkinson's plus syndromes often have a limited response to levodopa, a common medication for PD. 
• Progression and prognosis: Parkinson's plus syndromes typically progress more rapidly than PD and have a poorer overall prognosis. 

Common Parkinson's Plus Syndromes:

• Multiple System Atrophy (MSA): MSA affects multiple areas of the nervous system, including the autonomic nervous system (which controls things like blood pressure and digestion). Symptoms can include autonomic dysfunction, balance problems, and parkinsonian features. 
• Progressive Supranuclear Palsy (PSP): PSP is characterized by gaze palsy (difficulty with eye movements), postural instability, and cognitive and behavioural changes. 
• Corticobasal Degeneration (CBD): CBD is a rare neurodegenerative disease that primarily affects the cortex (outer layer of the brain) and the basal ganglia. Symptoms include limb rigidity, difficulty with coordinated movements, and cognitive decline. 

Find out more:

PSPA | A charity that helps those living with PSP and CBD

Multiple System Atrophy Trust

The Brain Charity