The vascular locked-in and locked-in-plus syndrome: A retrospective case series

The locked-in syndrome (LiS) is a severe neurological condition where a person loses almost all voluntary muscle movements but retains cognitive abilities. Some patients with LiS may also experience impaired consciousness; this is referred to as locked-in plus syndrome (LiPS). This study aimed to explore the structural differences in brain lesions between LiS and LiPS patients, particularly focusing on lesion patterns and locations. The goal was to better understand and differentiate between the clinical spectrum of LiS and LiPS. The researchers found that LiS patients tend to have lesions confined to the pons, while LiPS patients have lesions that are more elongated and extend to neighboring areas such as the mesencephalon and thalamus. Recognizing these differences is important for proper diagnosis, therapy, and care.

• 1
  Lesions in LiS patients are typically round and confined to the pons, the part of the brainstem responsible for motor control.
• 2
  LiPS patients tend to have more elongated lesions that extend beyond the pons to neighboring areas such as the mesencephalon and thalamus, areas critical for consciousness.
• 3
  Damage to the ascending reticular activating system (ARAS), especially dorsal extension within the pons, is crucial in differentiating LiS from LiPS, suggesting a direct impact on consciousness levels.