Dr. Keith Roach: Sensory stroke does not cause weakness
Dear Dr. Roach: I am an 84-year-old male in excellent health. In 2009, I had a stroke, which the doctors called a “sensory stroke.”
I was told that I was very lucky to come out of it with no paralysis. What I do have is partial numbness on my left side, especially in my left arm, hand and side of my face. I don’t have any pain.
The doctor prescribed gabapentin. I am taking 2,400 mg daily, which gives me some relief, but is by no means a cure.
Is there anything out there that might help me?
Dear R.L.G.: A stroke is a loss of brain function that does not immediately recover. It is due to the death of cells in the brain, but what part of the brain it happens in and how much of the brain is affected are of primary importance in determining the severity of stroke.
A stroke may impair strength, speech or cognitive functions.
A pure sensory stroke — one that does not cause weakness or loss of brain function — usually is due to damage to a small area of the thalamus, called a lacunar infarct (“lacuna” meaning “lake,”’ and “infarction” meaning “cell death”).
Recovery from strokes occurs most commonly in the six to 12 months after the stroke.
Gabapentin is frequently used for pain that is related to nerve damage, especially in people with pain as a result of shingles or due to diabetic neuropathy. Some people with thalamic strokes have terrible pain. However, gabapentin doesn’t always work for pain or numbness. When it does, it is rarely 100 percent effective. I wouldn’t recommend a higher dose than the one you are on; I often see people on doses that may be too low to be effective.
Other potentially effective medication options include pregabalin and amitriptyline; nonmedication options include sensory retraining therapy and massage.
Dear Dr. Roach: I frequently get laser light in my eyes when checking out books in the public library. The checkout person will sometimes hold the laser checkout light in such a manner that when he or she scans the bar code, it hits my eyes as well, or the check-out person, having scanned the item, does not place it back into a specifically designed holder. Do I need to worry about damage to my eyes?
Dear P.L.: Damage to the retina comes from high-powered lasers, especially green lasers. Some green laser pointers sold in the United States have a power of well over 5 milliwatts and may cause damage if pointed at the eye for even a short while.
The lasers used in grocery stores and libraries have far less power, normally less than 0.1 milliwatts, and are the much safer red color.
As far as I can find, no damage to the retina has been reported from a red laser below 3 milliwatts, let alone these very low-power lasers.
Still, you should never point a laser at someone’s face, and I would ask to speak with the head librarian about laser safety.
Email questions to ToYourGoodHealth@med.cornell.edu.