A syndrome that results in a patient only being able to control their eye
movement.
What is it?
Locked-in syndrome (LiS) happens when part of your brainstem, the pons,
is damaged. This usually occurs from a stroke. Other less common causes could be tumors on your pons or brainstem, demyelination, an infection, specific syndromes, or trauma. Locked-in syndrome is how it sounds: you are essentially “locked-in” your body. This syndrome is characterized by paralysis of voluntary muscles, excluding eye movement. All people who have LiS have their usual cognitive abilities. This means they can think, see, hear, and have reasoning like anybody else. They just can’t speak or move their body.
There are different types of LiS depending on the severity of the injury;
people with classical or partial LiS can only communicate with others through
vertical eye movements and blinking. If they have total immobility, they won’t be
able to communicate with their eyes, making it very difficult to diagnose.
How is LiS diagnosed?
There are several different tests used to help diagnose locked-in
syndrome. It can be challenging to diagnose due to often being mistaken for a coma.
These tests include:
EEG: To test the brainwave activity to see if there is normal brain activity and sleep- wake cycles. The EEG will help determine if someone is physically paralyzed but still conscious. People with LiS have normal sleep-wake cycles.
EMG: To rule out muscle and nerve damage. This could test to see if the patient has certain conditions like MS, ALS, and GBS, which could possibly cause LiS.
Medical imaging MRI/CT: To look for any damage to the brain, including the pons
Lab tests: metabolic panels, CSF examination to rule out infection or autoimmune conditions
Treatment/ Outlook:
There is no cure for LiS and treatment depends on the cause. People will
need a tracheotomy for breathing and a G-tube to receive food and water. There
are different types of therapies to help keep a person comfortable like physical
therapy and respiratory therapy for breathing exercises. There are also adaptive
technologies that can help people communicate.
LiS is extremely rare; people may recover some motor abilities, but a
complete recovery is unlikely. Due to advanced technologies, a person with LiS can
live a good quality of life.
Taylor Evans, R. EEG T.
References
Locked-In Syndrome: Causes, Recovery, and Life Expectancy (healthline.com)
Locked-in Syndrome (LiS): What It Is, Causes & Symptoms (clevelandclinic.org)
Locked-In Syndrome: Types, Symptoms, Causes, Diagnosis (verywellhealth.com)
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