By Randy Dotinga
The 58-year-old woman had tried just about everything to quit cigarettes, but she kept on puffing away. Then she had a stroke. Suddenly, her urge to smoke disappeared.
This recent case out of Cleveland of a stroke actually helping someone's health -- if only amid a blizzard of nasty effects -- suggests that our addictive urges aren't only a matter of conscious choice.
"Clearly, some strokes give us an insight into the biological basis of our behavior," said Dr. Cathy Sila, a neurologist at University Hospitals Neurological Institute, where the patient was treated. "There's sometimes more to smoking than just 'I choose to do this.' It's telling us something that we've got to figure out to help people quit smoking."
The woman's medical saga began when her family noticed she was acting strangely and sought help. Doctors diagnosed a stroke. She underwent a procedure to reduce a blockage in a neck artery and later went home.
A month after her stroke, the woman said she didn't care about smoking anymore and wasn't even tempted by being around other smokers. She also turned apathetic in general, a factor that could explain her lack of interest in cigs.
Her stroke may not go down in the annals of medical research. But other strokes have taught scientists about the workings of the brain for a century, said Dr. Brett Kissela, a neurologist at the University of Cincinnati. "By seeing what functions are lost from many, many strokes, we can learn about what each part of the brain does. This is similar to taking out one piece of a car at a time and then testing to see what doesn't work."
So what happened to this patient? The stroke may have damaged the frontal lobe, the place that holds "your ability to plan in advance and multi-task," Sila said. Or it could have disrupted the pleasure circuit in the brain, eliminating the woman's ability to get a kick out of smoking.
Whatever the case, things could change: Within months of a stroke, many patients recover the skills that they've lost. Patients tend to settle into a permanent state -- with or without stroke-related problems -- after about a year, Sila said.
In some rare cases like this one, stroke-related changes can be for the better. Sila recalls the case of an older patient who underwent a drastic personalty change after his stroke. "He was described by his family as an SOB: really mean, angry and bossy, not a very loving and nurturing kind of man. When he had a stroke, he totally chilled. He required help, assistance and supervision, but they liked him a lot better."
Call it that most unusual of medical disorders: a stroke of luck.
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