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Locked-in syndrome: a case report

F Budak1, A Ilhan, M Ozmenoğlu

  • 1Department of Neurology, KTU Medical School, Trabzon, Turkey.

Clinical EEG (Electroencephalography)
|January 1, 1994
PubMed

Insights

A man experienced locked-in syndrome caused by a ventral pontine infarction. Brain imaging confirmed the lesion, while electrophysiological tests remained normal, highlighting a specific neurological presentation.

Area of Science:

  • Neurology
  • Neuroimaging
  • Electrophysiology

Background:

  • Locked-in syndrome is a rare neurological condition characterized by complete paralysis of voluntary muscles except for vertical eye movements.
  • Ventral pontine infarction, a type of stroke affecting the pons, can lead to severe neurological deficits.

Observation:

  • A 46-year-old male presented with symptoms consistent with locked-in syndrome.
  • Magnetic Resonance Imaging (MRI) revealed abnormal signal intensities specifically in the ventral pons region.
  • Routine electroencephalography (EEG), brainstem auditory evoked potentials (BAEPs), and somatosensory evoked potentials (SEPs) were performed.

Findings:

  • The MRI findings localized the cause of the patient's condition to the ventral pons.
  • Despite the severe motor impairment indicative of locked-in syndrome, the EEG, BAEPs, and SEPs were all within normal limits.
  • This suggests that the infarction primarily affected motor pathways in the ventral pons without significantly impacting the analyzed sensory and cortical functions.

Implications:

  • This case highlights the importance of neuroimaging in diagnosing the specific etiology of locked-in syndrome.
  • The normal electrophysiological tests in the presence of a clear pontine lesion underscore the selective nature of the vascular insult.
  • Further research may elucidate the precise pathways affected and the implications for prognosis and management in similar cases.

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