Brainstem stroke syndrome

Brainstem stroke
Classification and external resources
Specialty	neurology
ICD-10	G46.3
ICD-9-CM	434.91

A brainstem stroke syndrome is a condition involving a stroke of the brainstem. Because of their location, they often involve impairment both of the cranial nuclei and of the long tracts. A person may have vertigo, dizziness and severe imbalance without the hallmark of most strokes – weakness on one side of the body. The symptoms of vertigo, dizziness or imbalance usually occur together; dizziness alone is not a sign of stroke. Brainstem stroke can also cause diplopia, slurred speech and decreased level of consciousness. A more serious outcome is locked-in syndrome.

Notable cases

Kate Allatt

Kate Allatt is a mother-of-three from Sheffield, South Yorkshire. She has successfully recovered from locked-in syndrome. Now she runs Fighting Strokes, and devotes her life to assisting those with locked-in syndrome.^[1]

Jean-Dominique Bauby

Parisian journalist Jean-Dominique Bauby suffered a stroke in December 1995, and, when he awoke 20 days later, he found his body was almost completely paralyzed; he could control only his left eyelid. By blinking this eye, he slowly dictated one alphabetic character at a time and, in so doing, was able over a great deal of time to write his memoir, The Diving Bell and the Butterfly. Three days after it was published in March 1997, Bauby died of pneumonia.^[2] The 2007 film The Diving Bell and the Butterfly is a screen adaptation of Bauby's memoir. Jean-Dominique was instrumental in forming the Association du Locked-In Syndrome (ALIS) in France.^[3]

Rabbi Ronnie Cahana

In the summer of 2011, Rabbi Ronnie Cahana of congregational Rabbi in Montreal suffered a severe brainstem stroke that left him in a locked-in state, able to communicate only with his eyes. With the help of his family he continued to write poems and sermons for his congregation, letter by letter, through blinking. He has since regained his ability to breathe by himself and speak with his mouth. He describes his experiences as a blessing and a spiritual revelation of body and mind.^[4] His story was told in a Ted talk given by his daughter called: "My Father, Locked-in his Body but Soaring Free". He is the son of painter Alice Lok Cahana.

Tony Nicklinson

Tony Nicklinson, of Melksham, Wiltshire, England, was left paralysed after suffering a stroke in June 2005,^[5] at age 51. In the years that followed, he started a legal battle for a right to assisted death. On 16 August 2012, his request was turned down by the High Court of Justice.^[6] On learning the outcome of his appeal, he refused to eat, contracted pneumonia, deteriorated rapidly and died a week later on 22 August 2012, aged 58.^[7]

Julia Tavalaro

In 1966, Julia Tavalaro, then aged 32, suffered two strokes and a brain hemorrhage and was sent to Goldwater Memorial Hospital on Roosevelt Island, New York. For six years, she was believed to be in a vegetative state. In 1972, a family member noticed her trying to smile after she heard a joke. After alerting doctors, a speech therapist, Arlene Kratt, discerned cognizance in her eye movements. Kratt and an occupational therapist, Joyce Sabari, were eventually able to convince doctors she was in a locked-in state. After learning to communicate with eye blinks in response to letters being pointed to on an alphabet board, she became a poet and author. Eventually, she gained the ability to move her head enough to touch a switch with her cheek, which operated a motorized wheelchair and a computer. She gained national attention in 1995 when the Richard E. Meyer of theLos Angeles Times published a cover story about Tavalaro. In 1997, Erika Duncan's profile of Julia and her co-author Richard Tayson, "Decades After Silence, a Voice Is Recognized," ran in the Long Island edition of The New York Times and in April 1997, "The Long Road Home" appeared in Newsday. Julia Tavalaro appears with Richard Tayson on Dateline NBC and Melissa Etheridge's Beyond Chance (Lifetime). Their book was published by Viking-Penguin in 1998 and was translated into German, where it was published as Bis auf den Grund des Ozeans by Verlag Herder. Tavalaro's story became a bestseller in Germany. She died in 2003 at the age of 68.^[8][9]

References

1. Sloan, Jenna (11 September 2012). "I'm mad on Facebook, shopping, 50 Shades of Grey and I like vodka: Amazing spirit of 'locked-in' Christine Waddell". The Sun. Retrieved 11 September 2012.
2. "The Diving Bell And The Butterfly". The A.V. Club. Retrieved 2007-11-29.
3. "Association du Locked In Syndrome" (in French). FR.
4. Rabbi Ronnie Cahana, Rabbi Ronnie Cahana's poetry and sermons
5. "Tony Nicklinson's legal fight for right to die". BBC News. 22 August 2012. Retrieved 22 August 2012.
6. "Locked-in man devastated at ruling". 18 August 2012. Retrieved 18 August 2012.
7. "Right-to-die man Tony Nicklinson dead after refusing food". BBC News. 22 August 2012. Retrieved 22 August 2012.
8. The Unspeakable Odyssey of the Motionless Boy by Joshua Foer, Esquire Magazine, October 2, 2008.
9. "Julia Tavalaro, 68; Poet and Author Noted for Defying Severe Paralysis". Los Angeles Times. December 21, 2003. p. B16.