Locked-in Syndrome

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Locked-in Syndrome Causes: Brain Hemorrhage

A brain hemorrhage is bleeding in or around the brain. Causes of brain hemorrhage include high blood pressure, abnormally weak blood vessels that leak, drug abuse, and trauma. Many people who experience a brain hemorrhage have symptoms as though they are having a stroke, and can develop:

  • weakness on one side of their body,
  • difficulty speaking, or
  • a sense of numbness.

Difficulty performing usual activities, including problems with walking or even falling, are not uncommon symptoms. About 10% of all strokes are hemorrhagic, or caused by bleeding into the brain.

Locked-in syndrome facts

  • Locked-in syndrome occurs when a person is quadriplegic and also has no way to produce speech or facial movements. The affected person cannot communicate but is aware of their surroundings; the patient can hear and see and has normal intelligence and reasoning ability but may only communicate with eye movements.
  • The main causes of locked-in syndrome are brainstem hemorrhage or infarct; rarely other causes such as trauma, tumors, or infection, for example, may cause the syndrome.
  • The symptoms and signs of locked-in syndrome include quadriplegia and the inability to speak or make facial movements, but those affected are aware and may communicate by eye movements.
  • The syndrome is often (about 50% of the time) discovered by the patient's family members that recognize awareness in their family member; MRI and eye-movement tests can help diagnose locked-in syndrome.
  • Although there is no specific treatment for locked-in syndrome, supportive care and communication by eye movements can help the patient survive and improve their quality of life.
  • Most locked-in syndrome patients do not recover lost functions; however, in rare instances, significant improvement in the condition may occur.
  • Statistics suggest that patients diagnosed with locked-in syndrome and given good supportive care that includes communication via eye movements may have a 80% chance of 10-year survival; the majority of patients who develop locked-in syndrome are adults that have increased risk for strokes.
  • For most patients with locked-in syndrome, the prognosis is fair to poor.
  • Although locked-in syndrome is usually not preventable, the risk of locked-in syndrome may increase in individuals with higher risk of stroke.
  • Other sources for more detailed information about locked-in syndrome are presented.
Medically Reviewed by a Doctor on 3/18/2016

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