Therapeutic approaches in locked-in syndrome

Papadopoulou, Soultana; Dionyssiotis, Yannis; Krikonis, Konstantinos; Lаgopati, Nefeli; Kamenov, Ivaylo; Markoula, Sophia

doi:10.3897/folmed.61.e39425

Cited by 6 publications

(13 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…30 To avoid pulmonary complications, which are the main cause of death, chest physiotherapy like deep breathing exercises, frequent position changes, postural drainage and suctioning is recommended. 164 Diaphragmatic pacing, which is established for spinal cord injured patients, is also an option that showed benefits for a LiS patient already. 165 Although a systematic review found insufficient evidence for the benefits of physical exercise in physical recovery of LiS patients, a positive trend was seen for muscle strength, tone, walking ability and activities in daily living and the need for well-designed studies was stated.…”

Section: Treatmentmentioning

confidence: 99%

Locked-in syndrome revisited

Schnetzer

McCoy

Bergmann

et al. 2023

Ther Adv Neurol Disord

View full text Add to dashboard Cite

The locked-in syndrome (LiS) is characterized by quadriplegia with preserved vertical eye and eyelid movements and retained cognitive abilities. Subcategorization, aetiologies and the anatomical foundation of LiS are discussed. The damage of different structures in the pons, mesencephalon and thalamus are attributed to symptoms of classical, complete and incomplete LiS and the locked-in plus syndrome, which is characterized by additional impairments of consciousness, making the clinical distinction to other chronic disorders of consciousness at times difficult. Other differential diagnoses are cognitive motor dissociation (CMD) and akinetic mutism. Treatment options are reviewed and an early, interdisciplinary and aggressive approach, including the provision of psychological support and coping strategies is favoured. The establishment of communication is a main goal of rehabilitation. Finally, the quality of life of LiS patients and ethical implications are considered. While patients with LiS report a high quality of life and well-being, medical professionals and caregivers have largely pessimistic perceptions. The negative view on life with LiS must be overthought and the autonomy and dignity of LiS patients prioritized. Knowledge has to be disseminated, diagnostics accelerated and technical support system development promoted. More well-designed research but also more awareness of the needs of LiS patients and their perception as individual persons is needed to enable a life with LiS that is worth living.

show abstract

Section: Treatmentmentioning

confidence: 99%

Locked-in syndrome revisited

Schnetzer

McCoy

Bergmann

et al. 2023

Ther Adv Neurol Disord

View full text Add to dashboard Cite

show abstract

“…Patterson and Garbois described 139 patients with LIS; 82 had an infarction in the pons' base. The other patients had different etiologies, such as trauma, central pontine myelinolysis, tumors, encephalitis, neuro-Behcet's disease, multiple sclerosis, and other etiologies of less frequency [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…While consciousness is impaired, there has been a report of impaired attention, executive function, and memory [ 4 ]. Respiration is often impaired in these patients when the lateral tegmentum is involved [ 5 ]. Anarthria is due to paralysis of the facial-glosso-pharyngo-laryngeal muscles and damage of the corticobulbar fibers [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Simultaneously, the sensory system is spared most of the time because of the sensory pathways' lateral location. However, the manifestations range from normal to absent [ 5 ]. Respiration is generally affected.…”

Section: Introductionmentioning

confidence: 99%

“…Respiration is generally affected. These patients can present with different respirations patterns like Cheyne-Stokes, apneustic, and ataxic [ 5 ]. Table 1 shows the main clinical features of LIS.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Locked-In Syndrome: A Systematic Review of Long-Term Management and Prognosis

Halan

Ortíz

Reddy

et al. 2021

Cureus

View full text Add to dashboard Cite

Locked-in syndrome (LIS) is a neurological disorder in which there is damage to the ventral pons and caudal midbrain. An ischemic cause, such as basilar artery occlusion, can often lead to LIS. LIS has three subtypes: classical, partial, and total. There is loss of motion in the four extremities in classical LIS, loss of horizontal gaze, and aphasia. In partial LIS, the patient still has some motor function. Complete LIS has the worst outcome because patients cannot blink or have vertical gaze, thus rendering them incapable of communicating. Most cases of LIS occur due to ischemic infarcts. These patients require a great deal of physical rehabilitation to regain partial motor ability and a means to communicate. While the clinical features and pathophysiology are known, the prognosis and long-term treatment remain unknown.We conducted a systematic review using the Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) protocol. We use an advanced PubMed strategy using the inclusion criteria of observational studies or clinical trials conducted in the last 20 years, written in English, and conducted on humans. We excluded systematic reviews, literature reviews, metanalysis, and studies that did not meet the outcomes of our objectives.The prognosis of LIS is not good, and most patients remain locked in, with poor quality of life, especially motor functions. Respiratory failure and depression are big comorbidities. In the acute setting, patients benefit from rapid intervention. The subacute treatment needs to manage aggressively to improve functional scores best. The long-term treatment focus is on the quality of life and managing comorbidities.

show abstract

Locked‐in syndrome: A qualitative study of a life story

Hordila,

García‐Bravo,

Palacios‐Ceña

et al. 2024

Brain and Behavior

View full text Add to dashboard Cite

IntroductionLocked‐in syndrome (LIS) is characterized by tetraplegia, anarthria, paralysis of cranial nerves, and facial musculature, with the preservation of consciousness and cognitive abilities, as well as vertical eye movements and eyelid movements, hearing, and breathing. Three types of LIS are distinguished: classic, incomplete, and total. The aim of the present study was to describe the life history of a person with LIS, as well as the wife's experience and perspective of this life history.MethodsA qualitative life history study was conducted with two participants: a 54‐year‐old man diagnosed with LIS and his 50‐year‐old wife. Data were collected through interviews and autobiographical documents submitted by the participants and analyzed following Braun and Clarke's method of inductive thematic analysis.ResultsFive main themes were identified: (1) how to understand and overcome the new situation; (2) the process of care and rehabilitation; (3) communication; (4) writing as a way of helping oneself and others; and (5) personal autonomy and social participation.ConclusionThe participants valued the support of their friends and family in the acceptance stage of the new situation, giving special importance to the communication skills and medical attention received after diagnosis.

show abstract

Therapeutic approaches in locked-in syndrome

Cited by 6 publications

References 69 publications

Locked-in syndrome revisited

Locked-in syndrome revisited

Locked-In Syndrome: A Systematic Review of Long-Term Management and Prognosis

Locked‐in syndrome: A qualitative study of a life story

Contact Info

Product

Resources

About