CATASTROPHIC REACTION AFTER STROKE - A CASE-STUDY

The catastrophic reaction is a rare affective disorder following left hemispheric strokes. It is characterized by a disruptive emotional out burst involving anxiety, agitation and aggressive behavior. A case is presented that appears to underscore the intense frustration that thes e individuals experience when they cannot adequately express themselve s through language. The catastrophic reaction behavior proved to be un remitting and failed to respond to withdrawal of the patient from thre atening or difficult therapies, use of medications or attempts at beha vioral modification. The catastrophic reaction appears to be a specifi c consequence of the intense frustration and perceived loss associated with an expressive aphasia. This may help explain the reportedly high er incidence of depression in left frontal strokes.