Locked-in syndrome

doi:10.1136/bmj.330.7488.406

BMJ 2005;330:406-409 (19 February), doi:10.1136/bmj.330.7488.406

Clinical review

Locked-in syndrome

Eimear Smith, specialist registrar in rehabilitation medicine¹, Mark Delargy, consultant in rehabilitation medicine¹

¹ National Rehabilitation Hospital, Dun Laoghaire, County Dublin, Ireland

Correspondence to: E Smith eimear.smith@nrh.ie

The first 150 words of the full text of this article appear below.

Introduction

The locked-in syndrome is caused by an insult to the ventralpons, most commonly an infarct, haemorrhage, or trauma. Thecharacteristics of the syndrome are quadriplegia and anarthriawith preservation of consciousness. Patients retain verticaleye movement, facilitating non-verbal communication. Ten yearsurvival rates as high as 80% have been reported. Even limitedphysical recovery can improve quality of life and enable patientsto return to live with their families. Early referral to a specialistrehabilitation service for specialist care and technology istherefore important.

Sources and selection criteria

We gathered information for this article through searches inMedline and Taylor and Francis Health Sciences, identifyingrelevant case series reviews on the locked-in syndrome and otherbrain stem strokes. Our own experience is also incorporated.

Clinical features

Locked-in syndrome was first defined in 1966 as quadriplegia,lower cranial nerve paralysis, and mutism with preservationof consciousness, vertical gaze, and upper eyelid movement.¹It was redefined in . . . [Full text of this article]

Classification

Diagnosis and early management

Recovery and prognosis

Development of communication devices

Quality of life for patients and carers

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

Technorati What's this?

Relevant Articles

The patient's journey: Living with locked-in syndrome: Nick Chisholm and Grant Gillett
BMJ 2005 331: 94-97. [Extract] [Full Text] [PDF]

Locked-in syndrome
BMJ 2005 330: 0. [Full Text]

This article has been cited by other articles:

(2007). Reference List for FOCUS Self-Assessment Examination. APPI Online CME 2007: 2-2 [Full text]
Lindsberg, P. J., Mattle, H. P. (2006). Therapy of Basilar Artery Occlusion: A Systematic Analysis Comparing Intra-Arterial and Intravenous Thrombolysis. Stroke 37: 922-928 [Abstract] [Full text]
G. Holloway, R., G. Benesch, C., Burgin, W. S., B. Zentner, J. (2005). Prognosis and Decision Making in Severe Stroke. JAMA 294: 725-733 [Abstract] [Full text]
Chisholm, N., Gillett, G. (2005). The patient's journey: Living with locked-in syndrome. BMJ 331: 94-97 [Full text]

Rapid Responses:

Read all Rapid Responses

An early account of locked-in syndrome: Andrew N Bamji
bmj.com, 28 Feb 2005 [Full text]
"Peripheral" locked-in syndrome and brainstem death: Alberto Primavera, et al.
bmj.com, 10 Mar 2005 [Full text]
Communication Chart: Eddie R. Ramsey
bmj.com, 18 May 2006 [Full text]
LIS & Communication Chart: Hana F Al-Ahmar, et al.
bmj.com, 29 May 2006 [Full text]
The sufferings, losses and complications of a person in Locked-in - syndrome.: Latha Rajendra kumar
bmj.com, 13 Dec 2007 [Full text]