Our sense of taste and smell are very closely linked. Problems with either of them can have a real impact, especially on the way we eat and drink.
How can your taste and smell change after stroke?
A stroke can affect your taste in a number of different ways, so you may:
not be able to taste things as well as you did before, so flavours may not be as obvious or strong
get a salty, bad or metallic taste in your mouth
lose your sense of taste completely.
If a stroke affects your sense of smell you may:
not be able to smell things as well as you did before, so smells may not be as strong
become oversensitive to smell, so that smells become really strong
have a distorted sense of smell
lose your sense of smell completely.
Why does it happen?
Your taste and smell can change because of damage to your brain.
If the part of your brain that controls and receives information from your senses is affected by your stroke, then this can cause problems with your taste and/or smell.
Other problems can also add to these changes. Although it can be difficult to maintain good oral hygiene when you’ve had a stroke, if your teeth and mouth aren’t clean and healthy this can affect your sense of taste. A virus or infection can also have an effect on your sense of taste and smell.
Because there is so much to deal with after a stroke, it’s normal for your behaviour to change in some way.
Why does behaviour change after a stroke?
The way we behave often depends on the way we feel. So if your emotions change after stroke, then your behaviour is likely to change too.
But it’s not just about the way we feel. Sometimes a stroke can also affect the way you respond to what’s going on around you. This can make you behave differently too.
Other effects of stroke will also affect your behaviour. Tiredness can mean you’re less active or talkative, for example. Or frustration at not being able to do things for yourself can build up and make you aggressive towards others.
In what ways can behaviour change?
It’s difficult to see changes in yourself. So, if you’re acting differently your friends and family are probably going to be the ones to notice.
These are some changes that other people may notice:
you get cross or annoyed very quickly
you’re more stressed, angry or aggressive
you’ve become withdrawn and don’t talk very much
you don’t show any interest in the things you used to enjoy
you make decisions without considering what will happen afterwards
you’re less inhibited, which can make you more out spoken or seem self-centred and can also change your sexual behaviour.
People may tell you that your personality has changed or that you’ve ‘become a different person’, which can be upsetting.
However, what they’re really noticing are changes to your behaviour, not who you are as a person – a stroke can’t change this.
Agnosia is the loss of the ability to recognize objects, faces, voices, or places. It is a rare disorder. If you have this condition you can still think, speak, and interact with the world. Agnosia usually affects only a single information pathway in the brain.
Types of agnosia
There are three main types of agnosia: visual, auditory, and tactile.
Visual agnosia occurs when there is brain damage along the pathways that connect the occipital lobe of the brain with the parietal and temporal lobes. The occipital lobe assembles incoming visual information. The parietal and temporal lobes allow you to understand the meaning of this information.
Apperceptive visual agnosia
Visual apperceptive agnosia causes difficulty in assembling parts of an image into an understandable whole. This condition may cause you to have difficulty understanding the relationship between objects.
You may, for instance, try to copy a picture of a circle and end up drawing a series of concentric scribbles. You can still use vision to navigate your environment and pick up objects without trouble. Apperceptive visual agnosia is usually caused by lesions to the parietal or temporal lobes on both sides of the brain.
Associative visual agnosia
Associative visual agnosia is the inability to recall information associated with an object. This can include an object’s name, use, or origin. This form of agnosia does not prevent you from being able to draw a picture of an object.
You may be unable to name the object in the drawing. You could recognize and use an object shown to you but may be unable to say what the name of the object is.
Prosopagnosia (face blindness)
Prosopagnosia is the inability to recognize faces. It’s caused by issues with the fusiform face area (FFA), a specific region of the brain that recognizes faces. Difficulty with facial recognition can also occur in Alzheimer’s disease. It happens because brain deterioration damages this region.
Autism can also cause difficulty recognizing faces. A 2014 article discussed how children with autism spectrum disorders may learn to recognize faces in a different way. They may find it more difficult to understand another person’s identity or emotional state.
Achromatopsia is the loss of color vision due to lesions in the V4 region of the brain. It’s the inability to name colors despite being able to perceive them. Color anomia results when a lesion separates the V4 regions of the brain from the language areas.
Agnosic alexia (pure alexia)
Pure alexia is the inability to recognize words visually. It is not possible to read with pure alexia. You can usually still speak and write without difficulty.
Akinetopsia (motion blindness)
Akinetopsia is the inability to perceive motion. This condition can cause you to see moving objects as a series of stills, like an object moving under a strobe light. If the condition is severe, you may not be able to see any motion at all.
Auditory agnosia is also known as pure word deafness. It’s the inability to recognize or process sounds despite intact hearing. It develops when the A1 sound-processing region of the brain is disconnected from its language centers. You can still read, write, and speak with pure word deafness.
Phonagnosia is the inability to recognize and identify familiar voices. It develops when the brain suffers damage to a certain part of the sound association region. This region is located in the right half of the brain. You can still understand words spoken by others if you have this condition. You can also recognize environmental sounds or sounds made by objects.
Tactile agnosia is the inability to recognize objects by touch. You may be able to feel the weight of the object. Yet you may be unable to understand the significance or the use of the object. Lesions in the parietal lobe of the brain are the cause of tactile agnosia.
Astereognosis is the inability to identify objects by touch alone. This condition makes you unable to associate information about size, weight, and texture with the right words. You can still name objects by sight. You are also able to draw pictures of objects, as well as reach for them.
Autotopagnosia is when you lose the ability to orient the parts of your own body. Damage to the left parietal lobe of the brain causes this condition. You are aware of where your limbs are in space at all times, even with closed eyes. But this awareness gets distorted when the brain’s internal representation of the body is damaged.
Problems with memory and thinking are very common after a stroke and most people will have some difficulties. Problems with concentration and memory are especially common.
Why do they happen?
Cognitive problems happen because of damage to your brain.
Every second you receive a huge amount of information from the world around you, which your brain has to understand, organise and keep.
If the part of your brain that processes this information is damaged, this can cause a number of problems.
What kind of problems do people have?
After a stroke, it’s common to find it difficult to concentrate or remember certain things. You may also find it difficult to work out how to do something or know how to respond to what’s going on around you.
You may find it difficult to:
follow a TV programme or read a book
remember what it is that you were doing
remember what someone told you only moments ago
find your way around
work out how to do things you used to do easily, like use the TV remote control or prepare a meal
notice things on one side of you.
A stroke is sudden and shocking and affects every part of your life. Most people who have had a stroke will experience some kind of emotional change afterwards.
Why does a stroke affect the way you feel?
Everyone’s experience of stroke is different, but for many people it feels like they’ve lost the life they had before.
Anyone who suffers a major loss will go through a range of emotions as they try to come to terms with it. Feelings of shock, denial, anger, grief and guilt are normal when you’re faced with such a major life change.
It can be very difficult to cope with the emotions you have after stroke. But if you don’t acknowledge the way you’re feeling and find things that can help you deal with it, these emotions can become overwhelming and lead to problems.
What kind of emotional problems happen after stroke?
People experience a wide range of emotions after stroke. All of them are entirely normal, but if they become overwhelming and you don’t get the support you need to help you deal with them, they can start to cause problems.
Problems with depression or anxiety are very common after stroke.
Many people also have problems controlling their mood and emotions. This is known as emotionalism (or emotional lability). It can mean that you cry or laugh more, sometimes for no reason at all. Some people start to swear, when they hadn’t used to before.
One of the emotions that nearly all stroke survivors have to deal with is frustration. If you don’t deal with your frustrations properly, they can build up and make you irritable, which can be difficult to live with. It can also lead to anger and aggressive behaviour.
Communication problems are very common after stroke. Around one third of stroke survivors have problems with speaking, reading, writing and understanding what other people say to them.
Why do they happen?
When we communicate our brain has to complete a series of tasks. Different parts of our brains are responsible for each of these tasks.
If one of these parts is damaged by a stroke, it can cause problems with communication.
What kind of communication problems do people have?
Aphasia affects your ability to speak and understand what others say. It can also affect your ability to read and write. It happens when you’re no longer able to understand or use language. Aphasia is a common problem after stroke and around a third of stroke survivors have it.
Dysarthria happens when you’re not able to control the muscles in your face, mouth and throat very well, so it’s diffcult to speak clearly. This can mean that your speech becomes slurred or slow or that your voice sounds quiet.
Apraxia of speech is when you can’t move the muscles in your face, mouth or throat in the order you need to when you’re speaking. This can make it difficult for other people to understand you.
Although some people assume that they do, communication problems do not affect your intelligence. If you have communication problems you simply have problems with the process of speaking and understanding language.
Continence is your ability to control your bladder and bowels. It’s very common for people to have problems with this after a stroke, especially in the very early stages.
Why do they happen?
There are a number of different reasons why you may have continence problems after a stroke.
Your stroke may have damaged part of your brain that controls your bladder and bowels.
If you’re not fully conscious or are very ill after your stroke, you may wet or soil yourself without realising it.
If your stroke has affected your ability to walk you may not be able to get to the toilet in time. Communication problems may make it difficult for you to let others know that you need the toilet as well.
Changes to your diet and not being able to get about very much can cause constipation, which can lead to continence problems.
If you had mild continence problems before your stroke, spending a lot of time in bed is likely to make them worse.
What kind of problems do people have?
You may have problems with your bladder, bowels or both. If you have problems with both your bladder and bowels, this is known as double incontinence.
If you have continence problems it may mean that:
you need to go to the toilet more often
your need to go may be sudden and you may not have time to get to the toilet
you wet yourself when you cough, sneeze or do something physical
you wet or soil yourself whilst you are sleeping
you wet or soil yourself at any time without realising it.