Hearing Loss After Stroke: Can They Hear You?

can a stroke patient hear you

A stroke occurs when the supply of oxygen-rich blood to the brain is interrupted. When brain cells are deprived of oxygen, they start to sustain damage, and swift treatment is required to restore blood flow and preserve brain tissue. As a result of a stroke, survivors can experience severe speech difficulties, such as aphasia, dysarthria, or apraxia of speech, which affect their ability to communicate. However, despite these speech impairments, stroke patients can often still hear and comprehend what is being said around them. This means that even if a stroke patient cannot respond, they can usually hear you.

Characteristics Values
Hearing Stroke patients can often hear, even if they can't speak.
People having a stroke are usually able to hear and comprehend what's happening around them.
Auditory overload Patients may be highly sensitive to sound, which can cause an inability to concentrate on a task or speaker.
Social gatherings can increase the likelihood of auditory overload.
Hearing loss Hearing loss is very common after a stroke.
Hearing disorders A stroke may affect all levels of the auditory pathway and lead to hearing reception and/or perception deficits.

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Stroke patients can often hear and understand, but not speak

A stroke occurs when the supply of oxygen-rich blood to the brain is interrupted. When brain cells are deprived of oxygen, they start to sustain damage, and swift treatment is required to restore blood flow and save brain tissue. Speech difficulties are most common after a stroke in the left hemisphere of the brain, where the language centres of the brain reside.

Aphasia is a language disorder that affects your ability to communicate. It is most often caused by strokes in the left side of the brain, which controls speech and language. Aphasia does not affect intelligence, and stroke survivors remain mentally alert, even though their speech may be jumbled, fragmented, or hard to understand. People with aphasia may struggle with communication in daily activities at home, socially, or at work, and they may also feel isolated.

Expressive aphasia involves the difficulty of producing speech while comprehension remains intact. A person with expressive aphasia can understand what is being said but struggles to form the words to communicate. On the other hand, people with fluent aphasia have trouble comprehending speech but can produce speech. Their speech often consists of incomprehensible jumbles of words, but they can say these words without issue.

A stroke patient with severe expressive aphasia will likely be able to hear and understand what is being said but will lack the ability to produce speech and communicate back. However, it is important to note that expressive aphasia does not apply to all cases, and some stroke patients may have their comprehension skills severely affected, preventing them from speaking because they cannot understand what is being said.

In addition to aphasia, a stroke patient may also experience dysarthria or apraxia of speech. Dysarthria is a motor speech disorder that causes difficulty controlling the muscles used for speech, resulting in consistently slurred or slow speech. Apraxia of speech is also a motor speech disorder, but it causes difficulty coordinating the oral muscles to form words, leading to inconsistent and unpredictable errors in speech.

While communication problems after a stroke can be challenging, they tend to improve with time and treatment. Speech and language therapists can help with many types of communication problems and can provide valuable support to stroke patients and their families. Rehabilitation methods, such as speech therapy, can help retrain the brain to control speech-associated skills. This process is intensive but often possible with rigorous and consistent therapy.

Additionally, singing therapy has been found to be a promising treatment for individuals who struggle to speak after a stroke. This is because singing taps into the creative skills of the right hemisphere of the brain, which remains unaffected by a stroke in the left hemisphere. Through singing therapy, stroke patients can learn to sing short phrases and eventually work towards saying those phrases.

It is important to remember that every stroke patient is unique, and the specific effects of a stroke depend on the area of the brain affected. While some may experience long-term communication problems, others may gradually improve over time with treatment and rehabilitation.

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Hearing loss is very common after a stroke

A study based in Taiwan, published in the journal Stroke in 2008, found a link between sudden sensorineural hearing loss (SSNHL) and the risk of stroke. SSNHL is defined as a hearing loss of at least 30 dB in three consecutive frequency ranges within a three-day timespan. The Taiwanese study examined data from 7,115 patients collected over five years, finding that those who had experienced SSNHL had a 1.64 times greater chance of stroke than the control group.

Another study, this time with a cohort of 44,460 patients, found that the incidence of SSNHL was approximately twice as high among stroke patients as among non-stroke patients. The risk of SSNHL was particularly high for stroke patients within one year of their stroke and those undergoing steroid therapy during hospitalization.

Hearing loss after a stroke can have a significant impact on a person's ability to communicate and can be highly stressful, potentially leading to rehabilitation non-adherence and social withdrawal. It is important for clinicians to be aware of the risk of hearing loss after a stroke and to carefully investigate the possibility of subsequent hearing impairments.

Additionally, people who have had a stroke may experience auditory overload, where their brain cannot keep up with the amount of sensory information it receives. This can lead to symptoms such as an inability to concentrate on a task or a speaker and repeating a task over and over. Parties and other social gatherings can increase the likelihood of auditory overload.

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Auditory overload is a common side effect of a stroke

Auditory overload: a common side effect of a stroke

After a stroke, patients may experience auditory overload, which is a common side effect. This is when the brain struggles to process the amount of sensory information it receives. The condition is also known as cognitive overload or fatigue and can be caused by extra background noise, movement, lights, and general chaos.

Symptoms of auditory overload

  • Inability to concentrate on a task or speaker
  • Repeating a task over and over
  • Increased anxiety
  • Irritability
  • Meltdowns

What to do to recover your senses

  • Distance yourself from noise as much as possible
  • Get lots of rest before attending large social gatherings. When tired, the auditory system will not process sound as effectively
  • Avoid excessive alcohol consumption
  • Ask the host to turn down or turn off music if it’s competing with people’s conversations
  • Wear earplugs to help reduce the intensity of the noise and decrease the amount of stimulation your system is trying to process
  • Stay hydrated—the brain functions best when it is fully hydrated
  • Avoid nicotine, caffeine, and alcohol, as they often make auditory overload symptoms worse

Auditory overload can happen at any time, but the likelihood increases in social situations, especially parties and other social gatherings.

How to help stroke patients with auditory overload

When helping patients and their caregivers develop coping skills for living with the after-effects of a stroke, consider sharing strategies to minimize stress and cognitive overload in social settings.

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Aphasia: a language disorder that affects your ability to communicate

Aphasia is a language disorder that affects your ability to communicate. It is caused by damage to the language-dominant side of the brain, usually the left side, in the areas that control spoken language. Aphasia can impact a person's ability to speak, write, and understand both spoken and written language. It can range from a full to a partial loss of language abilities.

Aphasia usually occurs suddenly after a stroke or head injury, but it can also develop gradually due to a slow-growing brain tumour or degenerative disease. The severity of aphasia depends on the cause and extent of the brain damage. It is a common effect of stroke, with about one-third of stroke patients experiencing some form of aphasia.

There are several types of aphasia, including:

  • Broca's aphasia, or expressive aphasia, where individuals may speak in short, meaningful sentences but struggle with repetition.
  • Wernicke's aphasia, or receptive aphasia, where individuals may speak in long, confusing sentences with unnecessary or made-up words and struggle with understanding others' speech.
  • Global aphasia, where individuals have significant trouble speaking or understanding language.

Treatment for aphasia involves addressing the underlying condition and speech and language therapy to re-learn and practice language skills. Nonverbal communication therapies, such as the use of computers or pictures, and group therapy for patients and their families are also beneficial.

It is important to note that individuals with aphasia may experience auditory overload, becoming highly sensitive to sound as their brains struggle to process a large amount of sensory information. This can be managed by reducing exposure to noise, getting sufficient rest, and using earplugs to reduce noise intensity.

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Speech therapy can help stroke patients regain the ability to talk

A stroke can affect a person's ability to hear, speak, and understand language. About a third of stroke survivors experience difficulties with speech, known as aphasia. This condition affects the ability to express oneself and understand others, and can range from mild to severe. While some people make progress within a few weeks, others experience years of slow recovery.

  • Tongue In-and-Outs: Sticking the tongue out and holding it for 2 seconds, then pulling it back in and holding for another 2 seconds. This helps train the tongue to move in coordinated patterns, improving speech production.
  • Side-to-Side and Up-and-Down Tongue Movements: Similar to the previous exercise, this involves touching the tongue to the right, left, and corners of the mouth, and reaching up toward the nose and down toward the chin. These exercises help improve oral motor skills.
  • Smiling: Smiling is a simple exercise that can improve facial muscle control. It is especially beneficial for those who have trouble moving one side of their face.
  • Consonant & Vowel Pairing Repetition: This involves pairing difficult-to-speak consonants with each of the five vowels (a, e, i, o, u) and repeating them. For example, practicing "ra, re, ri, ro, ru" for those who struggle with the "r" sound.
  • Sentence Production: Reading aloud provides an opportunity to practice speaking. This is beneficial for those with apraxia of speech, who have difficulty with tongue and lip movement but can understand and process language.
  • Phonological Processing: In this exercise, the patient guesses the number of syllables in words stated by a family member or caregiver. Feedback is essential, as it helps reinforce learning.
  • Singing Therapy: Singing words instead of speaking them can be effective, as singing activates the right hemisphere of the brain. This is useful when damage occurs in the language center of the left hemisphere.

Additionally, stroke patients can benefit from "real-life" activities, such as explaining the weather forecast to a friend, reading and responding to emails or texts, or discussing a TV show they plan to watch. These activities help improve communication skills and increase independence.

Frequently asked questions

Yes, stroke patients can often hear and understand what is being said around them, even if they can't speak.

A stroke may affect all levels of the auditory pathway and lead to hearing loss. Hearing loss after a stroke is less frequent than speech difficulties but is still common.

If a stroke patient is experiencing hearing loss, it is recommended that you consult a doctor or a speech-language pathologist for a diagnosis and treatment.

About 1 in 3 stroke patients have trouble with language, such as talking, understanding speech, reading, or writing. This is known as aphasia, which is a language disorder caused by strokes in the left side of the brain.

There are several ways to help a stroke patient communicate, such as writing pads, cue cards, pictures, gestures, and computer programs. Speech therapy and singing therapy can also help improve the patient's speech and communication skills over time.

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