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Locked in state. A clinicopathological study.

S C Sharma¹, R C Ray, A K Banerjee

¹Command Pathology Laboratory (CC), Lucknow.

The Journal of the Association of Physicians of India

|March 1, 1990

Summary

This summary is machine-generated.

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Acute pontine infarction can lead to a locked-in state, characterized by paralysis and mutism but preserved consciousness. Early signs include mild dysarthria and sensory/motor deficits.

Area of Science:

Neurology
Neuroscience
Pathology

Background:

The locked-in state is a rare neurological condition characterized by preserved consciousness with complete paralysis of voluntary muscles.
Understanding the underlying causes and early indicators of the locked-in state is crucial for diagnosis and management.

Observation:

Two patients presented with the locked-in state, exhibiting quadriplegia and mutism while maintaining an alert sensorium.
Initial symptoms included mild dysarthria and uncrossed hemisensory or hemimotor deficits affecting the face and ipsilateral extremities.

Findings:

Autopsy revealed rostral brainstem infarctions in both patients.
Acute onset of uncrossed hemisensory and hemimotor deficits with dysarthria suggests pontine infarction as a potential cause of the locked-in state.

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Implications:

Pontine infarction should be considered in the differential diagnosis of acute neurological deficits presenting with dysarthria and hemisensory/hemimotor loss.
Early recognition of these symptoms may aid in identifying patients at risk for developing the locked-in state, although prognosis remains poor.