Hallmarks of brain damage
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| Catastrophic reactions to stimuli | Psychological breakdown: 1-Reaction to external stimuli (can’t filter, sensory overload) 2-Internal reaction (depression, unable to manage emotional repercussions of condition) flight/fright response, panic attacks, feeling of impending doom.
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| Emotional lability (psuedobulbar) | 1-Uncontrollable crying - more likely with restricted verbal expression. 2-Internal LOC predisposes patient to depression. 3-Emotions = amygdala, limbic system, etc. - research hasn't found site for Tx.
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| Perseveration | 1-Doing something for a longer duration than is warranted, after stimulus has changed. 2-Echolalia (related). 3-Inability to shift set, reduced mental flexibility. 4-Clinical approach: start slowly, go from easy to more complex, give extra time.
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| Depression | Mood swings, loss of interest, isolation. Consider adolescent hormones, changes in depression pre- and post- brain damage, etc. Non-fluent patients are at greater risk because of awareness of their communication disability
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| Anosognosia | Denial of disability's existence (frontal cortex) - a conscious decision to ignore the problem, mental compensation for the loss. Impacts patient safety and ADLs (nutrition).
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| Visual neglect | Hemianopsia. Homonymous (both eyes). Cortical blindness. Hemialexia (reading only half the page).
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| Disinhibition | Inability to control or defer feelings. Can impact patient progress in therapy. Possible psych referrals for patients with emotional obstacles impeding Tx .
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| Memory deficits | Word retrieval problems. Type (TBI, CVA, etc.) or etiology (dementia) affects the way they manifest.
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| Euphoria | Heightened sense of well-being. Psychological issue, not sensory. They feel pain but deny it.
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