Related Experiment Videos
Locked-in syndrome: a catastrophic complication after surgery
1Department of Anaesthesia Intensive care and Pain Management, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. patrickbreen@eircom.net
British Journal of Anaesthesia
|January 15, 2004
Summary
Locked-in syndrome occurred in a 31-year-old after surgery for suspected metastasis. Extensive pontine tumor deposition caused this devastating neurological state, highlighting diagnostic and management challenges.
Area of Science:
- Neurology
- Oncology
- Neurosurgery
Background:
- Locked-in syndrome (LIS) is a rare neurological condition characterized by preserved consciousness but complete paralysis of voluntary muscles, except for vertical eye movements.
- This case involves a 31-year-old patient who developed LIS following a right upper lobectomy for suspected metastatic disease.
Observation:
- Post-surgery, the patient exhibited only vertical eye movement as a means of communication.
- The patient remained in a locked-in state for seven months.
- Vertical eye movement was the sole indicator of consciousness and communication.
Findings:
- Post-mortem examination revealed extensive metastatic tumor deposition in the ventral pons, the likely cause of the LIS.
- The pontine metastasis disrupted neural pathways controlling voluntary motor function while sparing consciousness.
Implications:
- This case underscores the critical importance of considering metastatic disease in the differential diagnosis of acute neurological deficits, even in young patients.
- Early recognition and management strategies for locked-in syndrome, though challenging, are crucial for patient care.
- Understanding the neuroanatomical basis of LIS is vital for improving diagnostic accuracy and therapeutic interventions.