Best Treatment for Stroke-Paralysis in India

What is Stroke or Paralysis?

A stroke usually occurs when blood supply to a certain part of the brain is interrupted or reduced. If the brain is deprived of proper blood supply, cells in this vital organs begin to die and within minutes, thereafter.

Paralysis is commonly referred to as a paralysis of part of the body muscles which is the inability to control the muscles in a given part of the body. That is why the paralysis arises due to the loss of function or impairment in the some sections of the brain that controls it.

• Indeed, if the stroke has occurred in the left side of the brain, the individual may have tendency to be paralyzed on the right side of the body and if the stroke has occurred on the right side of the brain the person may be paralyzed on the left side of the body.
• Paralysis occurs in the face area, arms, legs, and may extend to the whole body in case of a severe stroke.

Types of Stroke

Ischemic Stroke (most common – about 85% of cases)

This occurs when there is formation of a blood clot that either occludes or narrows the blood vessel supplying the blood to the brain.

Two main subtypes:

• Thrombotic Stroke: Blood clot or thrombus develops in the brain’s blood vessels and leads to a blockage of blood flow.
• Embolic Stroke: In this form, a blood clot or debris is formed in another region like the heart and then loosens to go to the brain.

Haemorrhagic Stroke (less common, but more dangerous)

• A condition that results from blood vessel rupture in the brain and tissues.

Two main subtypes:

• Intracerebral Hemorrhage: Bleeding directly into the brain tissue.
• Subarachnoid Hemorrhage: This is a condition whereby there is bleeding in the subarachnoid area which lies in between the brain and the tissue that covers the surface of the brain Known cause of this condition is a burst aneurysm.

Transient Ischemic Attack (TIA) – "Mini-stroke"

• In this process, oxygen supply to the brain is stopped for just 3-60 minutes. Three minutes of oxygen loss in the brain can cause irreversible brain damage.
• These are effects that are not permanent but are the indications that if proper check-up is not done, an actual stroke may be expected in the near future.

Cryptogenic Stroke

• A stroke with no clear cause even after medical testing.
• Occur in approximately 30-40 % of the patients who are afflicted with ischemic strokes.

Brain Stem Stroke

• It is commonly observed that it can affect both right and left side of the body.
• Can result in serious signs such as respiratory distress, speaking and swallowing problems and finally lose consciousness.

Symptoms of Stroke and Paralysis

Symptoms of Stroke:

• Their causes are with the rapid and unexpected onset.
• Tingling or relaxation of the face, arm, and/or leg — on one side of the body.
• Facial paralysis — the person may have a crooked smile or the inability to raise an eyeball upwards.
• This involves impairment in the motor function involving the arm such that the affected arm cannot be raised to full extent.
• A speech disorder that affects the person’s ability to speak fluently or understand speech.
• Sudden confusion or trouble understanding
• Ocular disorders including blurriness of vision or darkness of vision in one or both eyes
• Sudden dizziness or loss of balance and coordination
• Severe headache with no known cause (especially in hemorrhagic stroke)

Symptoms of Paralysis after Stroke:

• Loss of muscle control (partial or complete):
• Paralysis – inability to move portions of the body such as the face, arm or leg in one particular side of the body.
• Weakness in the muscles
• Numbness or loss of sensation
• Difficulty walking or maintaining balance
• Difficulties in fine motor control or motor planning (as seen when putting buttons on a shirt).
• If the throat muscles are also paralyzed, then the person has to struggle in swallowing food as well.
• Drooling or facial muscle droop
• Incontinence (trouble controlling bladder or bowel)

Causes of Stroke and Paralysis

Causes of Stroke:

This is usually resulted from a blockage or reduced blood flow in part of the brain. Main causes include:

• Blocked Artery
• Burst Blood Vessel
• Transient Ischemic Attack
• Other Medical Conditions: Heart Diseases, Diabetes, Obesity, Smoking, Excessive Alcohol Use
• Family History

Causes of Paralysis:

Paralysis on the other hand occurs when there is a malfunction in the muscles which is as a result of the damage on the brain.

Damage to Motor areas of the brain:

• In most cases, stroke is a condition that tends to limit the blood supply to the areas of the brain that is involved in controlling movements and coordination.

Nerve pathway interruption:

• The brain is unable to make signals to muscles to function as they used to do it.

Severe brain swelling or bleeding:

• This leads to pressure and additional harm of brain tissues.

Secondary complications:

• Some symptoms (as muscle stiffness or weakness) may become more severe and lead to paralysis if a person does not seek treatment.

Stroke Treatment Options

Treatment of Ischemic Stroke (Obstructed Blood Flow)

Clot-dissolving Medications

tPA (Tissue Plasminogen Activator):

• Administered intravenously (IV) within 3 to 4.5 hours of stroke onset.
• Disolves the clot and reopens the blood vessels.

Mechanical Thrombectomy

• A physician guides a device into a blood vessel to remove the clot mechanically.
• Typically performed within 6 to 24 hours of symptom onset.

Blood Thinners

• Drugs such as aspirin or anticoagulants (e.g., warfarin) to stop future clots.

Stenting and Angioplasty

• a balloon is inserted to open up blocked blood vessels, and occasionally a stent (small tube) is inserted to keep it from closing.

Hemorrhagic Stroke (Bleeding in the Brain) Treatment

• Control Bleeding and Reduce Pressure
• Medications to lower blood pressure, stop seizures, and decrease brain swelling.

Surgery

If there's severe bleeding or a ruptured aneurysm:

• Clipping: A small clamp is inserted at the base of the aneurysm.
• Coiling: Small coils are placed to cut off blood flow to the aneurysm.
• Surgical evacuation of large clots (hematomas) if necessary.

Repair Blood Vessels

• Surgery can repair abnormal blood vessels (such as arteriovenous malformations, AVMs) to stop future bleeding.

Physiotherapy for Stroke Paralysis

Major Forms of Paralysis Physiotherapy:

Passive Movements (Initial Phase)

Physiotherapist slowly moves paralyzed limbs.

Prevents stiffness (contractures) and maintains joint mobility.

Strengthening Exercises

Gradually increase muscle strength.

Example: lifting light weights, resistance bands, grip exercises of the hands.

Balance and Coordination Training

Train the brain to regulate the body once more.

Example: unaided sitting, standing exercises, practice of steps.

Gait Training (Walking Therapy)

Learn to stand and walk again using:

Parallel bars

Walkers, canes

Treadmill walking with support (robotic equipment in some facilities)

Functional Training

Practice in real life:

Getting out of bed

Sitting in a chair

Walking up stairs

Dressing, bathing, eating

Electrical Stimulation
Weak electric pulses on muscles to assist movement if there is severe weakness.

Mirror Therapy

Reflecting in a mirror to "fool" the brain into believing paralyzed limb is moving — enhances recovery!

Constraint-Induced Movement Therapy (CIMT)

Non-affected arm/leg is immobilized to compel use of the affected side.

Home Exercise Program

Individualized exercises the patient performs every day at home.

Electrical Stimulation for Stroke Recovery

What it is:

• Electrical stimulation (also referred to as E-Stim or NMES) applies small, harmless electrical impulses to stimulate weak muscles following a stroke.
• It stimulates muscles to move again by "awakening" nerves that lost their way due to brain injury.

How it Works:

• Sticky pads (electrodes) are applied to the skin over weak muscles (such as arms, hands, or legs).
• A mild electric current flows through, causing the muscle to contract (tighten) and relax naturally.
• The brain relearns how to move the muscle again with time.

Stroke Recovery Timeline

First 24 Hours

• Close hospital care.
• Doctors stabilize breathing, blood pressure, and treat the cause of the stroke.
• Some patients already have small improvements.

First Week

• Early physiotherapy starts (muscle movement of arms, legs, sitting up).
• Speech and swallowing tests are performed.
• Doctors and therapists look at how much damage has occurred.

First Month (0–4 weeks)

Greatest recovery window. Brain is highly active healing.

Physiotherapy, occupational therapy, and speech therapy occur daily.

Patients may:

• Regain basic movements.
• Sit, stand, or walk a short distance (with assistance).
• Begin simple self-care (eating, grooming).

Months 1–3

Rapid improvement in strength, coordination, and communication.

Most stroke survivors:

• Gain more ability to walk.
• Use their arms more.
• Talk more clearly.
• Home exercise therapy becomes extremely important.
• Emotional shifts such as depression or frustration may surface — counselling can assist.

Months 3–6

Recovery continues, but generally slower than during the first 3 months.

Some will resume:

• Working (if stroke was mild).
• Independence (with minor assistance).
• Others may continue to require therapy for weakness of the arm/legs or speech.

6 Months to 1 Year

Improvement continues but could be slow.

Work on:

• Fine motor function (writing, fastening shirts).
• Complex movement (running, dancing).
• Most patients have adjusted to their "new normal" at the end of 1 year.
• Consistent exercise continues to enhance strength and brain pathways.

After 1 Year

• Full recovery can occur in the long term, but progress is slower.
• Some individuals recover almost completely.
• They may have lifelong disabilities but can easily adjust with therapy and assistive tools.