What is Locked-In Syndrome?

One of the worst possible consequences of a severe injury to the brain or spine is locked-in syndrome. Victims of this syndrome are almost entirely paralyzed. They can’t move any part of their body except possibly their eyes. While they can’t move, however, their mind remains conscious and active.  

This is a rare condition, but some professionals think locked-in syndrome may occur more often than is recognized or diagnosed. Patients suffering from this condition are very rarely able to make a full recovery. However, there are always opportunities for treatment to improve quality of life and help patients adapt to their new circumstance. 

Causes

Locked-in syndrome generally occurs as a complication of some injury or disease that affects the brain stem or the central nervous system. The total paralysis can be triggered by a severe traumatic brain injury or some kind of condition that cuts off the flow of blood to the brain stem. That can be a stroke, a tumor, or some other kind of hemorrhage.

This condition has also been known to be caused by some kinds of poison and snake venoms that affect the nervous system but can’t cross the into the brain. Other diseases that attack nerve cells can also lead to locked-in syndrome. 

Diagnosis

Locked-in syndrome can be complicated to diagnose. It may be underreported because it is hard to recognize or verify a patient’s ongoing, conscious brain activity in spite of their paralysis. Others around the patient can help medical professionals to recognize this condition by paying attention to signs of awareness like active and responsive eye movement. The patient may be able to hear and understand what’s going on around them but can’t respond except by following things with their eyes and sometimes blinking. 

Doctors diagnose locked-in syndrome by using a variety of tests to explore and understand the causes of the paralysis and observe brain activity. MRIs can help find possible damage to the brain or blood clots. Electromyography can be used to study a patient’s nervous system and help track down the cause of paralysis. 

Confirming this diagnosis also requires an EEG to monitor brain activity, verify that it’s normal and check for standard responses. If the doctor can see the brain responding on the EEG to active stimuli around them or even pain, they can confirm that the patient is fully alert and aware. 

Treatment

Recovery from this type of total paralysis depends on the cause. Some patients can gradually regain some basic movement and speech ability with extensive therapy treatments over time. However, for many patients, treatment is simply about trying to adapt and improve their quality of life in spite of their new, limited circumstances. 

Many victims of locked-in syndrome need continued help for eating and even for breathing. Even if a patient never recovers from the paralysis, however, new technologies can let people communicate and even speak, simply by scanning their eye movement. A diagnosis of locked-in syndrome is only the first step on a difficult journey, but it doesn’t mean an individual’s life is over.  

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