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ALS patients on TPPV: totally locked-in state, neurologic findings and ethical implications
Hideaki Hayashi1, Edward Anthony Oppenheimer
1Department of Neurology (Dr. Hayashi), Tokyo Metropolitan Neurological Hospital, Japan.
Neurology
|July 9, 2003
Abstract:
Seventy patients with ALS using tracheostomy positive pressure ventilation (TPPV) were evaluated for impaired communication. Severely impaired communication is divided into the totally locked-in state (TLS) and the minimal communication state (MCS). TLS occurred in 8 of 70 (11.4%). In the 33 patients on TPPV for more than 5 years, TLS developed in 6 (18.2%) and MCS in 11 (33.1%). Respiratory management for ALS allows long-term survival if mechanical ventilation is used.