Locked - in syndrome - wikipedia Locked - in syndrome Locked - in syndrome Synonyms Cerebromedullospinal disconnection, de-efferented state, pseudocoma, ventral pontine syndrome Locked - in syndrome can be caused by stroke at the level of the basilar artery denying blood to the pons, among other causes. Specialty Neurology, Psychiatry Locked - in syndrome ( LIS ), also known as pseudocoma, is a condition in which a patient is aware but can not move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking. The individual is conscious and sufficiently intact cognitively to be able to communicate with eye movements. The EEG is normal in locked - in syndrome. Total locked - in syndrome, or completely locked - in state ( CLIS ), is a version of locked - in syndrome wherein the eyes are paralyzed as well. Fred Plum and Jerome Posner coined the term for this disorder in 1966. Contents 1 Signs and symptoms 2 Causes 3 Diagnosis 3.1 Similar conditions 4 Treatment 5 Prognosis 6 Research 7 See also 8 References 9 Further reading 10 External links Signs and symptoms Locked - in syndrome usually results from quadriplegia and the inability to speak in otherwise cognitively intact individuals. Those with locked - in syndrome may be able to communicate with others through coded messages by blinking or moving their eyes, which are often not affected by the paralysis. The symptoms are similar to those of sleep paralysis. Patients who have locked - in syndrome are conscious and aware, with no loss of cognitive function. They can sometimes retain proprioception and sensation throughout their bodies. Some patients may have the ability to move certain facial muscles, and most often some or all of the extraocular muscles. Individuals with the syndrome lack coordination between breathing and voice. This prevents them producing voluntary sounds, though the vocal cords are not paralysed. Causes In children, the most common cause is a stroke of the ventral pons. Unlike persistent vegetative state, in which the upper portions of the brain are damaged and the lower portions are spared, locked - in syndrome is caused by damage to specific portions of the lower brain and brainstem, with no damage to the upper brain. Possible causes of locked - in syndrome include : Poisoning cases -- More frequently from a krait bite and other neurotoxic venoms, as they can not, usually, cross the blood -- brain barrier Brainstem stroke Diseases of the circulatory system Medication overdose Damage to nerve cells, particularly destruction of the myelin sheath, caused by disease or osmotic demyelination syndrome ( formerly designated central pontine myelinolysis ) secondary to excessively rapid correction of hyponatremia ( > 1 mEq / L / h ) ) A stroke or brain hemorrhage, usually of the basilar artery Traumatic brain injury Result from lesion of the brain - stem Curare poisoning mimics a total locked - in syndrome by causing paralysis of all voluntarily controlled skeletal muscles. The respiratory muscles are also paralyzed, but the victim can be kept alive by artificial respiration, such as mouth - to - mouth resuscitation. In a study of 29 army volunteers who were paralyzed with curare, artificial respiration managed to keep an oxygen saturation of always above 85 %, a level at which there is no evidence of altered state of consciousness. Spontaneous breathing is resumed after the end of the duration of action of curare, which is generally between 30 minutes and eight hours, depending on the variant of the toxin and dosage. Diagnosis Locked - in syndrome can be difficult to diagnose. In a 2002 survey of 44 people with LIS, it took almost 3 months to recognize and diagnose the condition after it had begun. Locked - in syndrome may mimic loss of consciousness in patients, or, in the case that respiratory control is lost, may even resemble death. People are also unable to actuate standard motor responses such as withdrawal from pain ; as a result, testing often requires making requests of the patient such as blinking or vertical eye movement. Brain imaging may provide additional indicators of locked - in syndrome, as brain imaging provides clues as to whether or not brain function has been lost. Additionally, an EEG can allow the observation of sleep - wake patterns indicating that the patient is not unconscious but simply unable to move. Similar conditions Amyotrophic lateral sclerosis Bilateral brainstem tumors Brain death ( of the whole brain or the brain stem or other part ) Coma ( deep and / or irreversible ) Guillain -- Barré syndrome Myasthenia gravis Poliomyelitis Polyneuritis Vegetative state ( chronic or otherwise ) Treatment Neither a standard treatment nor a cure is available. Stimulation of muscle reflexes with electrodes ( NMES ) has been known to help patients regain some muscle function. Other courses of treatment are often symptomatic. Assistive computer interface technologies, such as Dasher combined with eye tracking, may be used to help people with LIS communicate with their environment. Prognosis It is extremely rare for any significant motor function to return. The majority of locked - in syndrome patients do not regain motor control. However, some people with the condition continue to live much longer, while in exceptional cases, like that of Kerry Pink and Kate Allatt, a full spontaneous recovery may be achieved. Research New brain - computer interfaces ( BCIs ) may provide future remedies. One effort in 2002 allowed a fully locked - in patient to answer yes - or - no questions ; others reported in 2017 having repeated this result with a larger study. In 2006, researchers created and successfully tested a neural interface which allowed someone with locked - in syndrome to operate a web browser. Some scientists have reported that they have developed a technique that allows locked - in patients to communicate via sniffing. See also Akinetic mutism Lock In, a near - future science fiction novel by John Scalzi Martin Pistorius, the author who wrote the autobiographical book Ghost Boy The Diving Bell and the Butterfly Johnny Got His Gun References Jump up ^ Nordgren RE, Markesbery WR, Fukuda K, Reeves AG ( 1971 ). `` Seven cases of cerebromedullospinal disconnection : the `` locked - in '' syndrome ``. Neurology. 21 ( 11 ) : 1140 -- 8. doi : 10.1212 / wnl. 21.11. 1140. PMID 5166219. Jump up ^ Flügel KA, Fuchs HH, Druschky KF ( 1977 ). `` The `` locked - in '' syndrome : pseudocoma in thrombosis of the basilar artery ( author 's trans. ) ``. Dtsch. Med. Wochenschr. ( in German ). 102 ( 13 ) : 465 -- 70. doi : 10.1055 / s - 0028 - 1104912. PMID 844425. Jump up ^ Duffy, Joseph. motor speech disorders substrates, differential diagnosis, and management. Elsevier. p. 295. Jump up ^ Bauer, G. ; Gerstenbrand, F. & Rumpl, E. ( 1979 ). `` Varieties of the locked - in syndrome ''. Journal of Neurology. 221 ( 2 ) : 77 -- 91. doi : 10.1007 / BF00313105. PMID 92545. Jump up ^ Chaudhary, Ujwal ; Xia, Bin ; Silvoni, Stefano ; Cohen, Leonardo G. & Birbaumer, Niels ( 2017 ). `` Brain -- Computer Interface -- Based Communication in the Completely Locked - In State ''. PLOS Biology. 15 ( 1 ) : e1002593. doi : 10.1371 / journal. pbio. 1002593. Jump up ^ Agranoff, Adam B. `` Stroke Motor Impairment ''. eMedicine. Retrieved 2007 - 11 - 29. Jump up ^ Plum, F ; Posner, JB ( 1966 ), The diagnosis of stupor and coma, Philadelphia, PA, USA : FA Davis, 197 pp. ^ Jump up to : Fager, Susan ; Beukelman, Dave ; Karantounis, Renee ; Jakobs, Tom ( 2006 ). `` Use of safe - laser access technology to increase head movements in persons with severe motor impairments : a series of case reports ''. Augmentative and Alternative Communication. 22 ( 3 ) : 222 -- 29. doi : 10.1080 / 07434610600650318. PMID 17114165. Jump up ^ Bruno MA, Schnakers C, Damas F, et al. ( October 2009 ). `` Locked - in syndrome in children : report of five cases and review of the literature ''. Pediatr. Neurol. 41 ( 4 ) : 237 -- 46. doi : 10.1016 / j. pediatrneurol. 2009.05. 001. PMID 19748042. Jump up ^ Aminoff, Michael ( 2015 ). Clinical Neurology ( 9nth ed. ). Lange. p. 76. ISBN 978 - 0 - 07 - 184142 - 9. Jump up ^ Page 357 in : Damasio, Antonio R. ( 1999 ). The feeling of what happens : body and emotion in the making of consciousness. San Diego : Harcourt Brace. ISBN 0 - 15 - 601075 - 5. Jump up ^ Page 520 in : Paradis, Norman A. ( 2007 ). Cardiac arrest : the science and practice of resuscitation medicine. Cambridge, UK : Cambridge University Press. ISBN 0 - 521 - 84700 - 1. Jump up ^ Oxymoron : Our Love - Hate Relationship with Oxygen, By Mike McEvoy at Albany Medical College, New York. 10 / 12 / 2010 Jump up ^ For therapeutic dose of tubocurarine by shorter limit as given at page 151 in : Rang, H.P. ( 2003 ). Pharmacology. Edinburgh : Churchill Livingstone. ISBN 0 - 443 - 07145 - 4. OCLC 51622037. Jump up ^ For 20-fold paralytic dose of toxiferine ( `` calebas curare '' ), according to : Page 330 in : The Alkaloids : v. 1 : A Review of Chemical Literature ( Specialist Periodical Reports ). Cambridge, Eng : Royal Society of Chemistry. 1971. ISBN 0 - 85186 - 257 - 8. Jump up ^ León - Carrión, J. ; van Eeckhout, P. ; Domínguez - Morales Mdel, R. ; Pérez - Santamaría, F.J. ( 2002 ). `` The locked - in syndrome : a syndrome looking for a therapy ''. Brain Inj. 16 ( 7 ) : 571 -- 82. doi : 10.1080 / 02699050110119781. Jump up ^ Maiese, Kenneth ( March 2014 ). `` Locked - in Syndrome ''. Jump up ^ Locked - in syndrome at NINDS Jump up ^ Joshua Foer ( October 2, 2008 ). `` The Unspeakable Odyssey of the Motionless Boy ''. Esquire. Jump up ^ Piotr Kniecicki `` An art of graceful dying ''. Clitheroe : Łukasz Świderski, 2014, s. 73. ISBN 978 - 0 - 9928486 - 0 - 6 Jump up ^ Stephen Nolan ( August 16, 2010 ). `` I recovered from locked - in syndrome ''. BBC Radio 5 Live. Jump up ^ `` Woman 's recovery from ' locked - in ' syndrome ''. BBC News. March 14, 2012. Jump up ^ Parker, I., `` Reading Minds, '' The New Yorker, January 20, 2003, 52 -- 63 Jump up ^ Keiper, Adam ( Winter 2006 ). `` The Age of Neuroelectronics ''. The New Atlantis. pp. 4 -- 41. Archived from the original on 2016 - 02 - 12. Jump up ^ Chaudhary, Ujwal ; Xia, Bin ; Silvoni, Stefano ; Cohen, Leonardo G ; Birbaumer, Niels. `` Brain -- Computer Interface -- Based Communication in the Completely Locked - In State ''. PLOS Biology. Retrieved 2 February 2017. Jump up ^ Karim AA, Hinterberger T, Richter J, Mellinger J, Neumann N, Flor H, Kübler A, Birbaumer N. `` Neural internet : Web surfing with brain potentials for the completely paralyzed ''. Neurorehabilitation & Neural Repair. 40 ( 4 ) : 508 -- 515. Jump up ^ `` ' Locked - In ' Patients Can Follow Their Noses ''. Science Mag. 26 Jul 2010. Retrieved 27 Dec 2016. Further reading Piotr Kniecicki ( 2014 ). An Art of Graceful Dying. Lukasz Swiderski ISBN 978 - 0 - 9928486 - 0 - 6 ( Autobiography, written while residual wrist movements and specially adapted computer ) External links Classification ICD - 10 : G93. 8 ICD - 9 - CM : 344.81 MeSH : D011782 The Unlock Project Locked - in Syndrome Association 's guide to communicating without language ( in French ) Rachel 's Communication boards -- for when you need to communicate with someone with LIS. OptiKey ( 1 ). Disorders of consciousness General Minimally conscious state Persistent vegetative state Related Locked - in syndrome Chronic coma Brain stem death Cerebral palsy and other syndromes ( G80 -- G83, 342 -- 344 ) Paresis and plegia NOS Paralysis Quadriplegia Triplegia Hemiplegia / Hemiparesis Paraplegia / Diplegia Monoplegia Flaccidity vs. spasticity Upper motor neuron lesion : Pseudobulbar palsy Spastic diplegia Spastic paraplegia Hereditary spastic paraplegia Lower motor neuron lesion : Bulbar palsy Flaccid paralysis Specific types Cerebral palsy Cauda equina syndrome Locked - in syndrome Lesions of spinal cord and brain Spinal cord / vascular myelopathy sensory : Sensory ataxia Tabes dorsalis motor : Motor neurone disease mixed : Brown - Séquard syndrome cord syndrome ( Posterior Anterior Central / Syringomyelia ) Subacute combined degeneration of spinal cord ( B12 ) Cauda equina syndrome Anterior spinal artery syndrome Brainstem Medulla ( CN 8, 9, 10, 12 ) Lateral medullary syndrome / Wallenberg PICA Medial medullary syndrome / Dejerine ASA Pons ( CN 5, 6, 7, 8 ) Upper dorsal pontine syndrome / Raymond Céstan syndrome Lateral pontine syndrome ( AICA ) ( lateral ) Medial pontine syndrome / Millard - Gubler syndrome / Foville 's syndrome ( basilar ) Locked - in syndrome Internuclear ophthalmoplegia One and a half syndrome Midbrain ( CN 3, 4 ) Weber 's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud 's syndrome dorsal, tumor Nothnagel 's syndrome Claude 's syndrome Other Alternating hemiplegia Cerebellum lateral ( Dysmetria Dysdiadochokinesia Intention tremor ) medial ( Cerebellar ataxia ) Basal ganglia Chorea Dystonia Parkinson 's disease Cortex ACA syndrome MCA syndrome PCA syndrome frontal lobe : Expressive aphasia Aboulia parietal lobe : Receptive aphasia Hemispatial neglect Gerstmann syndrome Astereognosis occipital lobe : Bálint 's syndrome Cortical blindness Pure alexia temporal lobe : Cortical deafness Prosopagnosia Thalamus Thalamic syndrome Other Subclavian steal syndrome Upper motor neurone lesion ( Clasp - knife response ) Lower motor neurone lesion Retrieved from `` https://en.wikipedia.org/w/index.php?title=Locked-in_syndrome&oldid=856531086 '' Categories : Neurotrauma Syndromes Hidden categories : CS1 German - language sources ( de ) Infobox medical condition ( new ) Articles with French - language external links Talk Contents About Wikipedia Čeština Dansk Deutsch Español Esperanto فارسی Français Italiano עברית Қазақша Magyar Nederlands Polski Português Русский Suomi Türkçe 中文 10 more Edit links This page was last edited on 25 August 2018, at 22 : 00 ( UTC ). Text is available under the Creative Commons Attribution - ShareAlike License ; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia ® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. About Wikipedia

Question: what condition results in a patient being aware but unable to move
Answer: Locked-in syndrome (LIS)