The clinical features of a mild stroke may include an extremely diverse group of effects, or symptoms. These include changes in sensation, changes to patterns of movement, weakness or paralysis, emotional disturbances and changes to speech. All, or only some of these mild stroke symptoms may be present in any particular case.
The first thing to be affected may be the senses, particularly the sense of touch, and this can have a dramatic impact on the capacity of the person for rehabilitation. For example, a lack of sensation on the hemiplegic (paralysed) side can often make it difficult for the person to comprehend what is required. A lack of perception combined with loss of sensation can lead to a great risk of injury. For instance, the person may not be able to feel heat, which means they need a much greater awareness of where their limbs are in space if they are to avoid being scalded or burned.
The thing that will be most obvious to those around the person with mild stroke symptoms will be the abnormal patterns of movement. This may be caused by abnormal tone, sensory deficit, loss of balance or equilibrium and righting reactions. For example, when bringing food from the plate to the mouth the arm may go into a flexion pattern.
Paralysis (or plegia) is the most easily recognisable symptom of stroke. The paralysis may be just a weakness where the stroke has been a mild one. This weakness happens on the side of the body opposite to the lesion in the brain. The face, neck and trunk muscles can be involved as well as the arms and legs. The tone of the muscles alters following a stroke and may be either reduced (hypotonicity) or increased (hypertonicity, or spasticity).
Many people suffer emotional disturbances after a stroke, even a mild one. They can become emotionally labile, for example laughing or crying at inappropriate times. This can be very distressing both for the person and their carers, family or relatives. The lability tends to pass, but it can give way to depression, frustration and aggression. This is particularly the case where the stroke has also caused communication disorders.
Speech and language disorders normally occur where the person has a lesion in the left hemisphere. If the muscles involved in speech are weak (or paralyzed) speech can become slurred, although there is no real loss of language. The language deficits are known are ‘dysphasia’ and this can mean that the person either cannot express themselves through speech (although they can still understand the spoken word), or they may lose the capacity to comprehend the spoken word.