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What Do You Need to Know About Locked-In Syndrome?

By Dr. Manoj Khanal in Neurosciences

Jun 01 , 2018 | 2 min read

There are over 600 neurological disorders. Each one has its own shocking complications and symptoms that prove the fact that human mind is way more complex than what we conceive. Even a simple defect in the smallest of the nerves can result in challenging complications.

While you may have heard of common neurological conditions like brain tumor disease or may even know about brain stroke symptoms or brain tumour treatment, there are various other neurological conditions you might have never heard. One such rare neurological disorder is “Locked-In Syndrome”.

Also known as pseudocoma, Locked-In Syndrome (LIS) is a condition in which the patient loses the ability to move all voluntary muscles except for some like blinking of the eyes. To put it in simple words, the patients suffer from a complete paralysis where though they are aware of their surroundings, it is impossible for them to make any movement or use verbal communication. Another condition known as total locked-in syndrome causes paralyses even to the eyes; thus, barring communication.

Here is what you need to know about locked-in syndrome:

Signs and Symptoms

The syndrome is mainly characterized by the complete loss of movement in the voluntary muscles. However, there are some other signs and symptoms as well which may vary from one patient to another.

Patients suffering from locked-in syndrome are not able to speak or make any facial movement. The only way they can communicate is through blinking or eye movements. They can understand everything that happens around them and recognize people as their cognitive function remains unaffected during locked-in syndrome.

Causes

Locked-in syndrome is often caused by damage to a specific part of the brain known as pons which contains the important neuronal pathways between the cerebellum, spinal cord and cerebrum. A damage to this part interrupts the movement of motor fibers running from grey matter in the brain causing paralysis. Here are some of the causes and conditions that may lead to locked-in syndrome:

  • Amyotrophic Lateral Sclerosis (ALS)
  • Brainstem stroke
  • Traumatic brain injury
  • A stroke or brain hemorrhage
  • Lesion of the brain stem
  • Infection in the certain part of the brain
  • Poisoning from krait bite or other neurotoxic venoms

Diagnosis

There are various other disorders like Akinetic mutism and a Guillain–Barré syndrome that exhibit symptoms similar to that of locked-in syndrome. This makes it difficult to recognize the occurrence of locked-in syndrome and hence the delay in treatment. Therefore, it is vital that one should seek medical consultation from hospitals that have an excellent neurological department.

We at Max Healthcare have highly experienced neurologists who have specializations in all type of neurological disorders and neurosurgery like brain tumor surgery. Some of the diagnostic tests that are performed for locked-in syndrome include Magnetic Resonance Imaging, Magnetic Resonance Angiography and Electromyography.

Treatment

Though there is no specific treatment for locked-in syndrome, there are some therapies and supportive care methods that can increase the chances of recovery. In most of the cases, the doctors try to treat the underlying cause of the syndrome. They may also recommend tracheotomy to aid the patient in breathing.

Furthermore, to ensure that the patient gets enough nutrition, gastrostomy (where a feeding tube is inserted in the stomach) is performed as feeding and drinking via mouth is not possible. A special therapy called functional neuromuscular stimulation can also be used to stimulate muscle reflexes which can activate paralyzed muscles.

Another essential and effective treatment option is care, support and hope of the family members who can help the patient fight this unfortunate condition.