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.

How is locked-in syndrome diagnosed?

Locked-in syndrome may be difficult to diagnose in some patients initially because some patients may be comatose for a while and then develop locked-in syndrome; some patients with a new onset stroke may resemble individuals with locked-in syndrome. The diagnosis can be missed if eye movement (vertical and blinking) is not assessed in seemingly unresponsive patients. Evidence for locked-in syndrome can be seen with MRI imaging of the specific brain area that shows damage. In addition, PET and SPECT brain scans can further assess the patient's abnormality. About half of patients with locked-in syndrome are discovered (diagnosed) by family members that realize the patient is aware and able to respond (communicate), usually with their eye movements. Other tests such as EEGs show normal sleep-wake patterns.

What is the treatment for locked-in syndrome?

There is no specific treatment for locked-in syndrome. Supportive care is the main treatment for locked-in syndrome. Supportive care includes the following:

  • Breathing support
  • Good nutrition
  • Preventing complications of immobilization such as lung infections, urinary tract infections, and blood clot formation
  • Preventing pressure ulcers
  • Physical therapy to prevent contractures
  • Speech therapy to help in developing communication via eye blinks and/or eye vertical movements
  • Possibly, computer terminal control linked to the patient's eye movements

Infrequently, treatment of the underlying cause such as shrinking a tumor or rapidly treating a medical overdose may improve the patient's condition.

Medically Reviewed by a Doctor on 3/18/2016

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