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Locked-in syndrome.

Louis R Caplan1, Ikram Asad1

  • 1Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States.

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|March 27, 2026
PubMed
Summary
This summary is machine-generated.

Locked-in syndrome requires paralysis of communication pathways and preserved consciousness. Pontine base lesions, often from basilar artery occlusion or hemorrhages, are the primary cause.

Keywords:
Ponsbasilar arteryconsciousnessmidbrainparalysis

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Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Medicine

Background:

  • Locked-in syndrome is a rare neurological condition characterized by preserved consciousness but near-total paralysis.
  • It affects the ability to communicate through speech or movement, posing significant challenges for patients.

Purpose of the Study:

  • To define the essential prerequisites for diagnosing locked-in syndrome.
  • To identify the anatomical locations and common etiologies of lesions causing this condition.

Main Methods:

  • Review of clinical criteria for locked-in syndrome.
  • Analysis of neuroanatomical localization of lesions.
  • Examination of common vascular pathologies affecting the brainstem.

Main Results:

  • Locked-in syndrome necessitates both paralysis of motor pathways for communication and intact consciousness.
  • Lesions in the pontine base are the principal cause.
  • Infarction from basilar artery occlusion and pontine hemorrhages are the most frequent etiologies.

Conclusions:

  • Understanding the prerequisites and causes of locked-in syndrome is crucial for accurate diagnosis.
  • Pontine base lesions, particularly ischemic and hemorrhagic events, are key etiological factors.