Is This Delusion? Cognitive Changes After Stroke

Q: Is This Delusion? Cognitive Changes After Stroke

Hello： This may indicate cognitive impairment, as the patient seems to exhibit delusions and misidentifications. <br>It is advisable to seek assistance from a neurologist or psychiatrist. <br>Hong Wei-bin

Is this a delusional disorder?

Hello, Dr.
Hong: My father-in-law had a minor stroke last month, and his condition is currently very stable.
His speech and walking are all normal.
However, recently I've noticed that he often confuses things.
For example, when there is road construction, he says they are handing out flyers.
He confuses dumplings with soup dumplings.
He seems to only hear the beginning of what is said and fills in the rest incorrectly, which gives the impression of grasping at straws.
When I talk to him, he sometimes has difficulty understanding and misinterprets the meaning.
I would like to ask the doctor if this could be a sign of dementia.
Thank you for taking the time to respond amidst your busy schedule.
😊

Xiu, 30~39 year old female. Ask Date: 2022/04/14

Dr. Hong Weibin reply Neurology

Hello: This may indicate cognitive impairment, as the patient seems to exhibit delusions and misidentifications.
It is advisable to seek assistance from a neurologist or psychiatrist.
Hong Wei-bin

Reply Date: 2022/04/14

More Info

Cognitive changes following a stroke can indeed be complex and multifaceted. In your case, it seems your father-in-law is exhibiting some signs that could be indicative of cognitive impairment, which may or may not be related to the stroke he experienced. The symptoms you describe, such as confusion about events, misidentifying objects, and difficulty understanding conversations, could suggest a range of issues, including but not limited to early signs of dementia or post-stroke cognitive impairment.

After a stroke, especially a minor one, patients can experience a variety of cognitive changes. These changes can manifest as confusion, difficulty with memory, and challenges in understanding or processing information. The phenomenon you described, where your father-in-law misinterprets situations or objects (like confusing dumplings with buns), is known as "perceptual distortion" or "misidentification." This can occur due to damage in specific areas of the brain responsible for processing sensory information and language.

It's important to note that cognitive recovery after a stroke can be highly variable. Some individuals may experience a gradual improvement in cognitive function, while others may have persistent deficits. The fluctuation in cognitive abilities, where he might seem fine one moment and confused the next, is not uncommon. This variability can be attributed to several factors, including fatigue, emotional state, and the overall complexity of the cognitive tasks being presented.

Regarding your concern about whether these symptoms could be early signs of dementia, it is essential to differentiate between post-stroke cognitive impairment and dementia. While some cognitive changes after a stroke can resemble dementia, they are not necessarily indicative of it. Dementia is characterized by a progressive decline in cognitive function that interferes with daily life, whereas post-stroke cognitive impairment may improve over time or stabilize.

To assess the situation more accurately, it would be advisable to consult with a neurologist or a neuropsychologist who can conduct a thorough evaluation. This evaluation may include cognitive testing to assess memory, attention, language, and executive function. Additionally, neuroimaging studies, such as an MRI or CT scan, can help identify any structural changes in the brain that may be contributing to these cognitive issues.

In terms of management, cognitive rehabilitation therapy may be beneficial. This type of therapy focuses on improving cognitive skills through structured activities and exercises. It can help your father-in-law regain some of his cognitive functions and learn strategies to cope with any deficits.

In summary, while the symptoms you describe could be concerning, they do not definitively indicate dementia. It is crucial to seek a professional evaluation to determine the underlying causes of these cognitive changes and to develop an appropriate management plan. With the right support and interventions, many individuals can experience improvements in their cognitive function following a stroke.

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