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[The locked-in syndrome]
J L Delacour1, C Floriot, G Wagschal
1Service de Réanimation Polyvalente, Centre Hospitalier Paul-Morel, Vesoul.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1988
Summary
Locked-in syndrome involves complete paralysis but preserved consciousness, often misdiagnosed as coma. Early diagnosis and fibrinolytic therapy for vascular obstruction can be critical for these patients.
Area of Science:
- Neurology
- Critical Care Medicine
Context:
- Locked-in syndrome (LIS) is a rare neurological condition characterized by profound immobility with preserved consciousness.
- It is frequently misdiagnosed as coma, leading to delayed or inappropriate patient management.
- Understanding the diverse etiologies and clinical presentations of LIS is crucial for timely intervention.
Purpose:
- To highlight the diagnostic challenges and clinical features of locked-in syndrome.
- To discuss the potential causes, including vascular obstruction, and the importance of early recognition.
- To emphasize the necessity of intensive care and communication strategies for patients with LIS.
Summary:
- LIS results in complete paralysis of voluntary muscles, excluding eye movements and blinking, while consciousness remains intact.
- Vascular obstruction in the vertebral and basilar arteries is a primary cause, though etiological diversity exists.
- Communication is possible through preserved vertical eye movements and blinking, enabling eye-code systems.
Impact:
- Early diagnosis of vascular obstruction allows consideration of fibrinolytic therapy, potentially improving outcomes.
- Intensive care, including tracheostomy and ventilation, is vital for patient survival.
- Awareness among healthcare professionals that LIS patients are conscious and communicative is paramount for appropriate care and support.