Thursday, March 20, 2014

The neuroplastic model of hypersensativity reduction after stroke for fun!!

Hypersensativity after stroke can come in two basic flavors:

1. A touch (or some other stimulus that normally does not hurt) hurts. A lot. This is called allodynia.

2. Something that usually does hurt hurts a lot more that it should. In other words, it hurts a lot more than it might on the unaffetced side. This is called hyperalgesia.

So how might you treat this. Lets go to the never-ending neuoplastic well, shall we? We know that stroke damages the brain which may cause the altering and amplifiying of sensation. So what if we used the same process to reverse it? These are hypothetical (although some have been tested) so keep that in mind. So what are the neuroplastic model to treat? Possibilities include...

1. TENS (mild electrical stimulation). Dosage here.
2. A placebo. An example would be suggesting a manual therapy (like message or manipulation of the extremity) will help reduce it. Discussion here.
3. Comparison. Put the gel on the unaffected side and say, "See, its just a bit cold. We'll take exactly the same gel (it can even be done at the same time)and put it on the 'bad' side and they'll-hopefully-feel the same.
4. Mirror therapy. Set it up like this: Have him look only at the unaffected side as either the survivor or someone else gives the "good" limb the stimulus which is painful to the "bad" limb. It will look like its getting put on the affected side, but with no pain.

Further reading here.  Duscussion of the difference between hyperalgesia and allodynia here.


Linda said...

This is very interesting. I mildly bumped the side of my face last week... it was the next day before I could think straight for pain.

Do you have any information or links about over reaction with auditory and visual triggers? A sharp sound like a fire alarm and I am just about down on the ground with pain in the one ear and my balance goes. It lasts long beyond the sound.

Jim Sparks said...

My affected side is very sensitive to touch, so much so that any kind of contact is unpleasant. Same with cold. The only exception is contact with water when I swim. In that case, there is no difference at all between the affected and unaffected side.

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