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Friday, May 16, 2014

Parkinson's Disease

Shaking Palsy
“Parkinson's disease is a degenerative neurological disease causing functional disturbance, causes certain brain cells to die. They are the cells that help control movement and coordination. The disease leads to shaking (tremors) and troublewalking and moving”. To learn more go to

Parkinson's: Latest From the Experts

Saturday, May 10, 2014

Cutaneous T-Cell Lymphoma

CT-CL Overview

Cutaneous T-Cell Lymphoma Treatment: The Old and the New



The lymphatic system removes excess fluid from the body's tissues and returns it to the circulatory system. It also helps the body fight infections. It consists of lymphatic vessels, lymph nodes, and associated organs such as the spleen and tonsils. Lymph vessels form a network of tubes that reach all over the body.
Lymph capillaries are tiny thin-walled vessels that are located in the spaces between cells throughout the body. They collect excess fluid from cells and recycle it for use in the circulatory system.

A lymph node is a small organ of the immune system. They link lymph vessels together and are found throughout the body. Their main function is to filter lymph and to remove foreign particles that might cause infections.

Our immune system protects the body against disease by killing infectious particles and tumor cells. The most common response is to send antigens to fight the cells that might cause disease.

Damaged skin is defined by extensive cracking of skin surface. It can leave the skin open to infection.


The body responds to skin damage by using white blood cells to destroy any particles that might cause infection.

Monday, May 5, 2014

May - Stroke Awareness Month

What Is A Stroke?

A stroke is a brain attack!
For our brain to function, we need a constant blood supply, which provides vital nutrients and oxygen to the brain cells. A stroke happens when the blood supply to part of the brain is cut off and brain cells are damaged or die.
About a third of people who have a stroke make a significant recovery within a month. But most stroke survivors have long-term problems. It may take a year or longer for them to make the best possible recovery. Sadly, in the most severe cases, strokes can be fatal or cause long-term disability.

Strokes are sudden and have an immediate effect!
After stroke a person may become numb, weak or paralyzed on one side of the body. The speech may become slur. The person may find difficult to find words or understand speech. Some people lose their sight or have blurred vision, and others become confused or unsteady.
A stroke can damage mind and body.
Strokes affect people in different ways, depending on the part of the brain that was affected, how widespread the damage was and how healthy the person was before the stroke. But strokes can damage: 
  • bodily functions 
  • thought processes  
  • ability to learn
  • and how we feel and communicate.
A stroke is always a medical emergency!
It is important to be able to recognize the symptoms of a stroke and to get an immediate help.

Visual Stroke Symptoms and The FAST Test 
FACE, ARMS, SPEECH, and TIME - identifies the most common symptoms of a stroke.

Facial Weakness: Can the person smile? Has their face fallen on one side?
Arm Weakness: Can the person raise both arms and keep them there?
Speech Problems: Can the person speak clearly and understand what you say? Is their speech slurred?
If you see any one of these three signs, it’s TIME to call 911

The quicker a patient arrives at a specialist stroke unit, the quicker he/she receives appropriate treatment and the more likely he/she is to make a better recovery.

What Is A Stroke? - Narration and Animation by Cal Shipley, M.D.
Types of Strokes
There are two main types of strokes.
Ischaemic strokes - happen when something blocks an artery that carries blood to the brain.
There are several possible causes: 
  • a blood clot forms in a main artery to the brain 
  • a blood clot, air bubble or fat globule forms in a blood vessel and is carried to the brain 
  • a blockage in the tiny bloody vessels deep inside the brain.


Haemorrhagic strokes - happen when a blood vessel bursts and bleeds into the brain (a haemorrhage).
The haemorrhage may be due to: 
  • a vessel bursting within the brain itself, or 
  • a blood vessel on the surface of the brain bleeding into the area between the brain and the skull. 
Temporary symptoms may indicate a mini-stroke - Transient Ischaemic Attack (TIA). It is the same as a stroke, except that the symptoms last for a short amount of time and no longer than 24 hours. This is because the blockage in patient’s artery is temporary - it either dissolves on its own or moves, so that the blood supply returns to normal and patient’s symptoms disappear.

Although the symptoms may not last long, a TIA is still very serious. It is a sign that there is a problem and patients are at risk of going on to have a stroke. Because of this it is often called a 'warning stroke' it must be taken in a serious consideration and treated immediately.
Types of Strokes
https://www.youtube.com/watch?v=fz1sgTke_0U


Speech And Language Therapy After Stroke
It is estimated that around a third of people will have some level of communication difficulties (called aphasia or sometimes dysphasia) after a stroke. At least 40 % of stroke survivors will initially experience some difficulty swallowing, though many people recover their swallow quite quickly.

  • Difficulties with communication can affect patient’s social relationships, independence and self-confidence.
  • Swallowing problems can put a patient at risk of infection and affect his/her enjoyment of food.
Speech and language therapy may be helpful if a patient has the following difficulties: 
  • swallowing - including problems with coughing or choking when eating or drinking 
  • understanding language (called receptive aphasia) 
  • speaking, including speaking any words or saying the correct word (called expressive aphasia)
  • forming words and speech sounds due to weak muscles in your mouth (dysarthria) 
  • moving the muscles needed for speech in the correct order and sequence (dyspraxia), 
  • reading (dyslexia) or writing (dysgraphia).
Speech-Language Therapy: 
Working with a Patient with Fluent Aphasia

A survivor of an Ischaemic Stroke
Young People can have Aphasia ( Broca's) - Jack Hurley
Aphasia ( Broca's) - Jack Hurley Update 2011
Jack Hurley - Broca's Aphasia 2013 Update

Wernicke's aphasia

Wernicke's Aphasia

A stroke should be followed by a formal language assessment, like for instance, patient’s understanding of yes/no questions, e.g. Do you put your shoes on before your socks? The patient may be asked to describe the surroundings as a test patient’s spontaneous speech or asked to repeat simple phrases or sounds.
A stroke may also cause new problems, including loss of vision or memory, which can make communication more difficult.
There is some overlap between the tasks a patient will be asked to do for assessment and therapy. A therapist should keep checking patient’s progress.
The techniques a speech and language therapist uses to help with communication difficulties will depend on the particular problems a patient has.

Therapies that target the specific area of communication a patient finds difficult are most effective.
For example: 
  • If there is a difficulty understanding the meanings of words (receptive aphasia) a patient may be asked to match words to pictures, sort words according to their meaning and judge whether words have the same meaning. These activities aim to strengthen patient’s ability to remember word meanings and link them to the spoken and written forms of words.
  • If a patient presents difficulty finding the words he/she want to say (expressive aphasia) a therapy might include practicing naming pictures, judging whether words rhyme or not or repeating words a therapist says. A therapist may provide prompts, for example, making the first sound of a word or writing the first letter. A therapist may also show objects that patient can touch and see while speaking their names.
  • If a patient presents weak muscles in his/her mouth, he may initially need to do exercises to help improve the muscle strength. A speech and language therapist may also give an advice on body positioning and where the tongue, lips and jaw should go when producing particular sounds.
  • Difficulty controlling breathing muscles can force a patient to take a breath in the middle of a sentence. A speech and language therapist may teach a patient breathing exercises and how to plan pauses within sentences to help with this.
  • One approach to help dyspraxia is to use natural melodic patterns for everyday phrases. For example, the phrase ‘Good morning!’, when said very cheerfully, has an almost musical melody. A therapist can teach a patient to use this in an exaggerated way to co-ordinate a speech. As the patient’s speech improves, the melody and rhythm cues can be gradually dropped.
  • If a patient has difficulty making the right sounds in the right order to form words, a therapy should include tasks such as listening to differences between spoken words, repeating words of increasing length and developing the ability to monitor your speech.
  • Some people who can do tasks involving single words, such as naming pictures, have difficulty constructing sentences. A therapy should also work on patient’s ability to understand and produce simple and complicated sentences.
An important part of the speech and language therapist’s role involves finding alternative or additional ways of communicating, which may include: 
  • gestures 
  • writing 
  • communication charts 
  • a letter board, or 
  • drawing.
For some people an electronic communication aid may be beneficial so a speech and language therapist can advise on what would be helpful; may also help to family members on adapting communication to make it easier to understand.

Reading and writing
If a patient has problems with speech, it is quite likely that he/she will have problems with writing (dysgraphia), spelling and reading (dyslexia). The areas of the brain which are important for these tasks are quite close together. Therefor speech and language therapist may also help with reading and writing. This is because all ways of communicating use similar abilities; for example, finding the right words and constructing them into a sentence. However, if a patient has difficulty with one particular way of communicating, a therapy should focus on this.

How can my family help?
Communication problems can be frustrating and lonely for family and caregivers as well as for a person who has these difficulties. 
When therapy starts, a therapist will usually give written instructions so that a patient and his/her family can practice specific exercises between sessions. It may be helpful if a family member can attend some therapy sessions to observe the exercises, and help a patient to practice them.
The family should try to resist the temptation to do all the talking for the patient. Many people who have had a stroke are capable of understanding and producing speech but their speech may be slow at first. It is easy to overwhelm someone by asking more questions before they have had a chance to process the first one. For some people it can help to wait as long as half a minute. To begin with, family members can try asking questions that only need a ‘yes’ or ‘no’ answer. Later, they can increase the complexity, just like learning a foreign language. Repetition and hard work are important.

Thursday, May 1, 2014

Brain Injury, TBI and Non-TBI

Brain injury is a damage to the brain that may be caused by a traumatic injury to the head or by a non-traumatic cause such as a tumor, aneurysm, anoxia or infection.

Traumatic Brain Injury
A traumatic brain injury (TBI) is a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from "mild," i.e., a brief change in mental status or consciousness to "severe," i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long-term problems with independent function.

The leading causes of TBI are:
  • Falls (28%)
  • Motor vehicle-traffic crashes (20%)
  • Struck by/against (19%)
  • Assaults (11%)
  • Blasts are a leading cause of TBI for active duty military personnel in war zones.
What are the long-term consequences of TBI?
TBI can cause a wide range of functional changes affecting thinking, language, learning, emotions, behavior, and/or sensation. It can also cause epilepsy and increase the risk for conditions such as Alzheimer's disease, Parkinson's disease, and other brain disorders that become more prevalent with age.

Traumatic Brain Injury (TBI) Part I: 2D/3D Medical Animation by MediVisuals, Inc.
Traumatic Brain Injury (TBI) Part 2: 2D/3D Medical Animation by MediVisuals, Inc.

Traumatic Concussive Brain Injury by TrialFX (animation with no narration)

Traumatic Brain Injuries: Effects of damage to different lobes of the brain by Kershaw,Cutter & Ratinoff

Brain Injury (TBI) by MU School of Health Professions

Children and Traumatic Brain Injury (TBI) by MU School of Health Professions

Veterans and Traumatic Brain Injury (TBI) by MU School of Health Professions

Speech Therapy Following Traumatic Brain Injury (TBI) by MU School of Health Professions

Non-traumatic Brain Injury
A Nontraumatic Brain Injury can be the result of an illness, oxygen deprivation, metabolic disorders, aneurysms, cardiac arrest, near-drowning experience, etc. In short, it includes injuries to the brain that are not caused by an external physical force to the head. Other nonviolent circumstances like tumors and lead poisoning can also damage the brain. Even though the effects of a Nontraumatic Brain Injury are comparable to those affiliated with a Traumatic Brain Injury (TBI), there are some dramatic differences. Previously mentioned and most important, they do not feature any outer blow to the head. It also has a direct impact on cells throughout the brain. Since it attacks the cellular structure, a Nontraumatic Brain Injury has the ability to spread to all areas of the brain as opposed to TBI, which only affects concentrated areas.
The most common instances of Nontraumatic Brain Injury include:
  • Anoxic injury - brain receives inadequate levels of oxygen, usually following cardiac arrest when there is minimal to no blood reaching the brain.
Anoxic Brain Injury

Dangers of Carbon Monoxide
  • Toxic or metabolic injury - occurs after coming into contact with unsafe substances (e.g., lead) or the detrimental accumulation of chemicals manufactured within the body (e.g., kidney failure).
  • Encephalitis - caused by an infection of the brain.
Encephalitis
  • Virus - most popular agent of Nontraumatic Brain Injury.
  • Brain tumors and methods used to treat them - chemotherapy and radiation can lead to diffuse brain damage.
Brain Tumor Overview
  • Cerebral Aneurysm
Cerebral Aneurysm
  • Meningitis
Medical School - Meningitis: A Simple Review
  • Stroke
What Is A Stroke? - Narration and Animation by Cal Shipley, M.D.
  • Drug abuse
Teenage Drug Overdose - Brain Damage

Substance Use and Traumatic Brain Injury: Risk Reduction and Prevention
  • Hydrocephalus
Pediatric Playbook - Hydrocephalus

Hydrocephalus - Definition, treatment and complications

Brain Injury videos created by KPKinteractive for Shepherd Center

1. Introduction and About this Video - Brain Injury 101 by KPKinteractive

2. Brain Injury Basics and Anatomy of the Brain - Brain Injury 101 by KPKinteractive

3. Understanding Traumatic Brain Injury, its Causes, Effects and Classifications - Brain Injury 101 by KPKinteractive

4. Understanding Non-Traumatic Brain Injury and Stroke - Brain Injury 101 by KPKinteractive

5. Practical Advice for Coping with Brain Injury - Brain Injury 101 by KPKinteractive

About Brain Injury by Brain Injury Association of America http://www.biausa.org/
Check also other organization Brain Line, very informative Web http://www.brainline.org/

How effective are speech-language treatments for TBI?
The American Speech-Language-Hearing Association (ASHA) www.asha.org has written a series of treatmentefficacy summaries that describe evidence about how well treatment works. These summaries are useful not only to individuals with TBI and caregivers but also to insurance companies considering payment for much needed services for TBI.
What does a speech-language pathologist do when working with people with TBI?
A treatment plan is developed after the evaluation. The treatment program will vary depending on the stage of recovery, but it will always focus on increasing independence in everyday life.
In the early stages of recovery (e.g., during coma), treatment focuses on:
·   getting general responses to sensory stimulation
·   teaching family members how to interact with the loved one
As an individual becomes more aware, treatment focuses on:
·    Maintaining attention for basic activities
·    Reducing confusion
·    Orienting the person to the date, where he or she is, and what has happened
Later on in recovery, treatment focuses on:
·    finding ways to improve memory (e.g., using a memory log)
·    learning strategies to help problem solving, reasoning, and organizational skills
·    working on social skills in small groups
·    improving self-monitoring in the hospital, home, and community
Eventually, treatment may include:
·  going on community outings to help the person plan, organize, and carry out trips using memory logs, organizers, checklists, and other helpful aids
·    working with a vocational rehabilitation specialist to help the person get back to work or school
Individual treatment may continue to improve speech, language, and swallowing skills, as needed. If the person is learning how to use an augmentative or alternative communication device, treatment will focus on increasing efficiency and effectiveness with the device.
The Preferred Practice Patterns for the Profession of Speech-Language Pathology outline the common practices followed by SLPs when engaging in various aspects of the profession. The Preferred Practice Patterns for cognitive-communication assessment and intervention are outlined in sections 22 and 23. The Preferred Practice Patterns for a comprehensive speech and language assessment are outlined in section 10.
In 2003, ASHA developed a technical report that describes the role of the SLP in the management of individuals with TBI. Check http://www.asha.org/policy/TR2003-00146/ for
 “Rehabilitation of Children and Adults with Cognitive-Communication Disorder After Brain Injury”

Treatment Efficacy Summaries
ASHA has developed a series of treatment efficacy summaries that describe research findings about how well treatment works for different disorders. These summaries are useful not only to parents and caregivers but also to insurance companies considering payment for much needed services for adults and children with communication and related disorders.
Stuttering [PDF]