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Trapped- A Presentation on Locked-in Syndrome

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Jenson Thomas

on 29 August 2012

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Transcript of Trapped- A Presentation on Locked-in Syndrome

Trapped- A Presentation on
Locked-in Syndrome Locked-in syndrome is a rare neurological condition in which a patient is fully conscious, yet completely paralyzed, with the exception of the muscles that control eye movement. What causes locked-in
syndrome? What areas of
the brain are
affected by
locked-in syndrome? Causes of
syndrome Medication
Destruction of the
myelin sheath
around the axon
from a disease
or an infection Infarct Traumatic brain
injury Ruptured
aneurysm Hemorrhage Stroke There is no cure or standard course of treatment for
locked-in syndrome. Individuals who have
locked-in syndrome may receive support from:
1. Physical therapists
2. Occupational therapists
3. Speech and language therapists
4. Psychotherapists
5. Neurologists
6. Physiatrists

While interviewing Doctor Suarez, he offered some insight into treatment:
"Basically the most common cause is a stroke, so if you can get to those places very early on and you are able to give them interventions such as intravascular therapy, you may reverse the locked-in state, but if the patient doesn’t come in soon enough... they may remain in the locked-in stage for the rest of their life." The use of an AEIOU alphabet board
can allow patients to communicate
with family members and caretakers.
Infrared eye movement sensors and
computer voice prosthetics also allow
patients to communicate. What is the prognosis for
syndrome? The prognosis for locked-in syndrome is poor,
because there is no cure or standard treatment.
In some cases, therapy, as well as technology,
have allowed some individuals to regain
some motor functions. How severe is
locked-in syndrome? Locked-in syndrome is a serious condition, with
about 40-70% of patients dying within a short period of suffering the causative injury. However, Casanova et al reported that individuals who began
rehabilitation within one month of injury had a mortality rate of only 14% at five years. How do you
locked-In syndrome? In my interview with Doctor Jose Suarez, Medical Director of Vascular Neurology and Critical Care at St. Luke's Episcopal Hospital and Professor of Neurology at the Baylor College of Medicine, he discussed the method he uses to diagnose a suspected locked-in patent:
"Well, what we do is we come to the bedside and we always ask basically some questions to determine whether they are coherent or not and if they are not responding, the next step would be to try to open their eyes... and ask them some simple questions such as, 'Could you look to the left? Could you look to the right? Could you look up or down?' or, 'Could you blink once for yes and twice for no?'" What are the symptoms of locked-in syndrome? Symptoms of locked-in syndrome can include the following:
Unable to move all voluntary muscles, except for the muscles that control eye movement
Can think, reason, and remain conscious and aware
Normal wake and sleep cycles are preserved
Cannot speak, but can follow commands Ventral pons
Medulla So what is
locked-in syndrome? What are the treatments for
locked-in syndrome? Although there have been no comprehensive studies, the National Institution of Health estimates that as many as 50,000 individuals suffer from locked-in syndrome in the United States alone. How prevalent is locked-in
syndrome in the general public? AEIOU alphabet board. The assistant calls out the color and the patient signals the required color by an upward eye movement. The assistant then sequentially calls out the letters on that line. Once the patient has indicated the desired letter, it is written down. The combination of chosen letters are then combined to formulate a sentence, question, or statement. Copyright © 2005, BMJ Publishing Group Ltd
- Rosalyn Carson-DeWitt. “Locked-in Syndrome.” Healthline.com. The Gale Group Inc, 2005. Web. 9 Feb. 2012.
- “Locked-in syndrome.” eHealthwall.com. eHealthwall, n.d. n.p. Web. 7 Feb. 2012.
- Smith, Eimear and Delargy, Mark. “Locked-in syndrome.” BMJ 330(7488): 406-409. Web. 8 Feb. 2012.
- “Locked-in Syndrome.” Bobveillette.com. The Worx Group, n.d. n.p. Web. 10 Feb. 2012.
- Suarez, Jose. Personal Interview. 8 Feb. 2012. Work Cited: Locked-in syndrome can be classified into three categories:
Classic: complete paralysis of all voluntary muscles, except for the muscles that control eye movement
Incomplete: The same as classic, but with remnants of voluntary movement other than eye movement
Total: Complete inability to move or communicate, yet is fully conscious. The Diving Bell and the Butterfly: The Diving Bell and the Butterfly is a French memoir composed by Jean-Dominique Bauby, who developed locked-in syndrome after suffering a massive stroke on December 8, 1995; he was 43. After the stroke, Bauby, then the editor-in-chief of Elle magazine, "wrote" a book chronicling his life with locked-in syndrome and what it was like before his stroke. By blinking with his left eyelid, Bauby was able to compose the 139 page novel in 10 months (4 hours a day). The French version of the book eventually became a #1 bestseller across Europe, but not before Bauby died, just three days after the book was published.
Doctor Suarez encourages people to read the book, since, "I find that book extremely useful especially when trying to describe to family members about locked-in and it is a very vivid description about that experience."
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