Neuropathology in seven cases of locked-in syndrome

The neuropathology of 7 cases of the locked-in syndrome has been reviewed and compared with 3 cases of akinetic mutism, all of them occurring after brainstem vascular disease (9 infarctions, 1 hematoma). Including other published cases of verified locked-in syndrome, the extent of lesions has been studied in order to understand, among other symptoms, the preservation of consciousness, voluntary eye movements, auditory comprehension and vital functions. It is concluded that, at the time of autopsy, although most of the clinical signs can be explained by the pathological findings, it is not yet possible to individualize specific brainstem lesions responsible for this syndrome.