“The locked-in syndrome”: Can it be unlocked?

Abstract

a b s t r a c tLocked-in syndrome is one of the most disabling states characterized by the preservation of conscious mind within a quadriplegic and anarthric body. Recently, there has been increased public awareness about this rare condition, and more cases are reported. The commonest causative lesion is bilateral ventral pontine damage secondary to vertebrobasilar artery occlusion. Clinicians need to be familiar with the condition because there is a high chance of erroneous diagnosis, such as coma or vegetative state, after a prolonged unconscious state. It is often the relatives or carers who recognize the conscious state first and report that the patient can communicate through his eyes. Because of complications, such as aspiration and sepsis, about 40e70% of sufferers die in acute phase of illness. However, advancements in medical care, rehabilitation, and communication technology have enabled many chronic locked-in syndrome patients to lead meaningful lives in the society with the help of family and friends.

Are the irreversibly comatose still here? The destruction of brains and the persistence of persons

“…Bilateral ventral pontine lesions, for instance, result in locked-in syndrome. Affected patients are quadriplegic and suffer from the paralysis of all cranial motor nerves, with the exception of vertical eye movement 26. In spite of the extensive destruction of brainstem tissue, however, these patients are not comatose—owing to the fact that the lesions spare the ARAS’s core region 25.…”

Speech language characteristics and intervention approaches in lockedin syndrome post snake envenomation

“…Locked-in syndrome (LIS) can best be described as a disease process where the brain is fully functional while confined within a non-functional body. 1 The locked-in syndrome is a rare neurologic disorder defined by the presence of sustained eye-opening, preserved awareness, aphonia or hypophonia, quadriplegia, or quadriparesis and complete loss of speech and language.…”

Abordaje Fonoaudiológico de la Deglución en el Síndrome de Enclaustramiento

“…El LIS, es una patología poco frecuente, no heredable, de origen vascular o por traumas al tronco cerebral, la arteria basilar o los pedúnculos cerebrales, corticoespinal o corticopontinas que interrumpen la conexión corticobulbar (Khanna, Verma, & Richard, 2011); en Europa, ha sido catalogada como una enfermedad huérfana y clasificada por ORPHA bajo el código 2406 como una enfermedad neurológica rara (Orphadata, 2018), con una incidencia de 1/1.000.000.…”

“…En una serie de 50 pacientes crónicos con LIS, el 75% tuvo dificultad para tragar las secreciones orofaríngeas, lo que define un alto porcentaje de repercusiones deglutorias propias del quehacer del fonoaudiólogo. Sumado a la presencia de sialorrea y dificultades respiratorias (Khanna, Verma, & Richard, 2011).…”