Therapeutic Advances in Neurological Disorders, 2023 · DOI: 10.1177/17562864231160873 · Published: February 14, 2023
Locked-in syndrome (LiS) is a condition where patients are paralyzed but retain cognitive abilities, only able to move their eyes vertically and eyelids. There are different types of LiS, including classical, complete, and incomplete, with varying degrees of voluntary movement. A related condition, locked-in plus syndrome (LiPS), involves additional impairments of consciousness. The most common cause of LiS involves damage to the ventral part of the pons, often due to infarction or hemorrhage in the vertebrobasilar artery territory. However, other brain areas may also be involved. Diagnosis can be challenging, requiring careful clinical investigation and, in some cases, advanced imaging techniques like functional MRI or EEG. Despite the severe physical limitations, many individuals with LiS report a high quality of life. Rehabilitation focuses on establishing communication, managing symptoms, and providing psychological support. Brain-computer interfaces (BCIs) and other technical support systems play a crucial role in enabling communication and improving quality of life.
Early and accurate diagnosis of LiS is crucial to avoid misdiagnosis and ensure appropriate care. Standardized diagnostic procedures and consideration of LiS in patients with quadriplegia and anarthria are essential.
Early and interdisciplinary rehabilitation, including physical, speech, and occupational therapy, along with psychological support and assistive devices, can improve functional outcomes and quality of life for LiS patients.
Respecting the autonomy and dignity of LiS patients is paramount. Addressing misconceptions about their quality of life and involving them in treatment decisions are critical for ensuring ethical and patient-centered care.