Locked-in Syndrome: Aware but Unable to Move

Although rare, the extreme nature of Locked-in Syndrome makes it one of the most terrifying effects of a traumatic brain injury (TBI). Patients with Locked-in Syndrome are conscious and able to think, but paralysis of voluntary muscle control leaves them effectively “locked in” their own body. Patients maintain control of their eyes and are sometimes able to communicate via blinking and eye movements. Patients with Total Locked-in Syndrome are not able to control their eyes.

While locked-in syndrome can be the result of a TBI, it can also be caused by a stroke, overdose of medication or neurological disease. In all cases, the cause is damage to a part of the brain called the pons. The pons is located on the brain stem and links the cerebrum, cerebellum and medulla. Damaging this link removes voluntary muscle control because these signals – to raise your hand, for example – come directly from your brain. Although the patient can breathe, the inability to control their vocal chords prevents them from speaking. Vital functions, such as a heartbeat and the breath, are maintained via the spinal cord and do not require signals from the brain. The syndrome differs from a persistent vegetative state because of the location of the damage.  In locked-in syndrome patients, the upper areas of the brain are functional but are damaged in patients suffering in a persistent vegetative state.

Treatments

Unfortunately, a cure has not yet been discovered for locked-in syndrome, and patients are not known to regain voluntary motor function on their own. However, some basic treatments exist and research is ongoing into more advanced options. Neuromuscular electrical stimulation (NMES) is fairly basic but can help some sufferers regain limited muscle control. Electrodes are placed on the skin near the muscle to be affected. Electrical impulses are sent, mimicking the signal from the brain and causing the muscle to contract or relax.

A Dasher computer is another assistive device used by people with any ailment that makes computer keyboards impractical or impossible to use, including locked-in syndrome. The computer can be configured to convert the eye movements of a person with locked-in syndrome into words, greatly aiding communication.

In 2010, a team of Israeli scientists developed a computer program that can translate a patient’s sniffing into action. By wearing a device that looks like oxygen tubes used in a hospital, specific patterns of sniffing can send signals to a computer. The computer can translate the patterns into an email or allows the patient control of a wheel chair. Two short sniffs outward could be set to send a wheelchair forward, while two short inhales would mean stop. Or a short exhale followed by two short inhales may mean “turn right.” The same sniff-pattern concept would be used to type messages and emails.  While the technology is still being studied, it shows signs of promise. Additionally, it solves the problem suffered by those with total locked-in syndrome who are unable to use a Dasher computer via eye movements.

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If you have suffered a TBI or medical treatment that led to locked-in syndrome, the financial and emotional costs can be astronomical. Contact us to see if you may be entitled to compensation. Our attorneys specialize in cases related to the brain and neurological issues and offer a free consultation to help you determine the best course of action.

http://www.ninds.nih.gov/disorders/lockedinsyndrome/lockedinsyndrome.htm

http://news.sciencemag.org/sciencenow/2010/07/locked-in-patients-can-follow-th/

http://biausa.fyrian.com/about-brain-injury.htm – second impact syndrome

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