"Locked-in" syndrome. A clinico-pathological study of two cases

Two new examples of "locked-in" syndrome are reported. The patients are mute and quadriplegic; they present a bilateral horizontal gaze palsy. Contact can be established through preserved vertical eye movements demonstrating therefore that the patients are not comatose. Postmortem examination reveals in both cases a thrombosis of the basilar artery with an infarction of the ventral rostral pons extending dorsally into the paramedian tegmental area. The main clinical features of this syndrome and their anatomical correlates are discussed.