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Mom Wants to Escape

Question: My mom had three small strokes affecting her thalamus a week ago. She has been mostly cooperative, but one time while she was in the hospital she tried to escape and was refusing to do any of the things I told her to do. Now she is in rehab, and she is absolutely refusing to do anything they say. She says they are holding her prisoner. She thinks she’s in a mental hospital or some kind of crazy movie. She keeps trying to escape from the hospital.

She has all functioning limbs and everything, but her memory is severely impaired at this point. She was supposed to start her therapy today in the rehab hospital, and she has been very difficult. Is this common?

Answer: While strokes most commonly cause physical symptoms, manifestations of a thalamus stroke can include psychiatric symptoms like delusions and paranoia. The thalamus is a critical center in the brain, processing and transmitting sensory and motor signals and playing a key role in consciousness, memory, and emotion. Damage to certain areas of the thalamus has been linked to psychotic symptoms, including delusions (like persecutory delusions) and hallucinations. Though uncommon, a schizophrenia-like psychosis has been seen as the only sign of stroke in some cases.

Disruption of thalamic sensory processing and thalamo-prefrontal circuits, can potentially lead to delusional beliefs and behavioral changes that mimic primary psychiatric disorders. Consult with your mother's MD to see if there are meds or neuropsychological counseling that can help.

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