Q: My mother is 56 years old. She suddenly felt numbness in her left hand a few months back. At night she felt numbness in her left leg and the next day she almost became inactive. We took her to the doctor and a CT scan was taken. The impression reads as follows: Acute ischaemic infarct right basal ganglia and corona radiata corresponding to middle cerebral artery territory; Chronic infarct right middle cerebral artery posterior cerebral artery watershed region. She was admitted to the hospital and she is taking medicines on a continuous basis. She is also under physiotherapy treatment. The physiotherapists say that 100% normalcy will not be possible in her case. Is it true? How much time it will take her to recover to normalcy? Will she regain her normalcy? After three months of treatment she is able to walk slowly with help occassionaly. She feels heaviness and pain in the hand and is able to move the arm slightly. She feels as if an iron plate is inside her arms and wrist. This makes it very difficult for her to exercise. The wrist drop is still there with the continuous exercise.

A:Your mother has sustained damage to some of the important structures in her brain due to sudden lack of blood supply. The neurologic recovery in such patients is determined by the fact that some of the nerve cells, which have not been completely damaged, will recover in due course of time. But, there will always be some cells that will have sustained complete irreversible damage. Currently, there is no investigative modality that will give us this functional information in order that we can do the exact prognostication. But, this is not to loose heart. With physiotherapy, some patients can recover to almost near normal (never really full normal). The medication is more for keeping the blood thin etc. and that has to be taken in order that a further similar episode can be prevented. Something similar to the medication that one takes after a heart attack. There is no specific medication to improve nerve recovery. The nature helps in this recovery and we have to help nature by continuing the physiotherapy so that once the nerve cells are functioning, the muscles are maintained in a supple state to be able to follow the orders for movement, which will originate in those cells. Physiotherapy is done to maintain the muscles and joints in a state where they do not get contractures/ atrophied due to disuse. 1. There is no medication for neurological recovery 2. Physiotherapy must continue 3. The improvement that your mother has is fairly all right and will continue. Some recovery continues till as long as two years or even longer. The rate of recovery is faster initially and then becomes slow as we go along, so please continue with the exercises. 4. The idea of all the treatment is to see as to how much we can improve her quality of life and to help her gain a degree of independence in her daily activities. These are very common ailments and a lot of people do manage to become very independent.