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Locked-In syndrome
Locked-In syndrome is a condition in which a patient is aware and awake, but cannot move or communicate due to complete paralysis of nearly all voluntary muscles in the body. It is the result of a brain stem lesion in which the ventral part of the pons is damaged. The condition has been described as "the closest thing to being buried alive".[1] Locked-in syndrome is also known as Cerebromedullospinal Disconnection,[2] De-Efferented State, Pseudocoma,[3] and ventral pontine syndrome. The phrase "Locked-In syndrome" was created by Plum and Posner in 1966.[4][5] Additional recommended knowledge
PresentationLocked-in syndrome results in quadriplegia and inability to speak in otherwise cognitively-intact individuals. Those with locked-in syndrome may be able to communicate with others by coding messages by blinking or moving their eyes, which are often not affected by the paralysis. Patients who have locked-in syndrome are conscious and aware with no loss of cognitive function. They retain proprioception and sensation throughout their body. Some patients may have the ability to move certain facial muscles, most often some or all of the extraocular eye muscles. CausesUnlike persistent vegetative state, in which the upper portions of the brain are damaged and the lower portions are spared, locked-in syndrome is caused by damage to specific portions of the lower brain and brainstem with no damage to the upper brain. Possible causes of locked-in syndrome include:
TreatmentThere is no standard treatment for Locked-In syndrome, nor is there a cure. Stimulation of muscle reflexes with electrodes (Neuromuscular stimulation) has been known to help patients regain some muscle function. Other courses of treatment are often symptomatic.[6] New direct brain interface mechanisms may provide future remedies.[7] PrognosisIt is extremely rare for any significant motor function to return. The majority of locked-in syndrome patients do not regain motor control, but devices are available to help patients communicate. Assistive technologySee:
Notable caseParisian journalist Jean-Dominique Bauby had a stroke in 1995, and when he awoke 20 days later he found that his body had stopped working: he could only control his left eyelid. By blinking his eye he dictated a letter at a time and in this way he wrote The Diving Bell and the Butterfly.[8] Cultural references
References
Categories: Neurotrauma | Syndromes |
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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Locked-In_syndrome". A list of authors is available in Wikipedia. |