Doctors can run a series of tests to rule out other conditions and determine brain function to confirm a locked-in syndrome diagnosis. Diagnosing this condition is often difficult, and could take weeks, months, or even years before doctors become aware of a patient’s cognitive awareness. In many cases, doctors only diagnose a patient after the patient’s family brings their eye movements or other signs to the attention of doctors.
Diagnostic Tests to Confirm a Locked-In Syndrome Diagnosis
Magnetic Resonance Testing
Doctors use both magnetic resonance imaging (MRI) and magnetic resonance angiography to locate the damage to the brain stem, locate blood clots or blockages, and rule out damage to other parts of the brain.
An electroencephalogram (EEG) allows doctors to visualize brain activity by picking up the brain’s electrical currents. This should show that the patient has normal brain activity with no cognitive loss if they have locked-in syndrome.
Evoked Potentials Testing
Evoked potentials testing is a way doctors use an EEG test to check the patient’s response to stimulation. This allows them to identify awareness in patients with complete locked-in syndrome. They can also explore pain and sensation in patients with locked-in syndrome using this type of testing.
In conjunction with a nerve conduction study, electromyography may allow a doctor to prove paralysis is a result of a brain injury instead of injury to the nervous system or individual muscles.
Doctors Will Need to Discover the Cause of Locked-In Syndrome
Locked-in syndrome occurs because of damage to a part of the brain stem called the pons. Most commonly, this happens because of a stroke or hemorrhage that cause a blockage of blood flow or uncontrolled bleeding, respectively.
Other possible causes of locked-in syndrome include:
- A blood clot
- Traumatic brain injury
- Brain infection
- A tumor affecting the pons
- Myelinolysis or other conditions affecting the nerve cells
- Inflammation of the nerves sometimes called polymyositis
- Amyotrophic lateral sclerosis (ALS) and other motor neuron disorders
If there is no sign of external head injury that could indicate a traumatic brain injury from an accident, doctors will generally conduct a physical exam and watch for signs of a stroke or brain hemorrhage. Then, they will use a CT scan or MRI to take a look at what is going on inside the person’s brain. These tests allow them to identify blockages, bleeding, or tumors. Other potential causes require additional testing to diagnose.
Observing Patients with Locked-In Syndrome
In most cases, people with locked-in syndrome cannot speak or make purposeful movements of any part of their body except their eyes and eyelids. Many patients retain the ability to blink and make vertical eye movements, but cannot chew, swallow, or sometimes breathe on their own. They suffer from near-global paralysis. Their cognitive function and sleep-wake cycle remain intact.
These people are aware of their environment and can comprehend what is happening around them. They can hear and see in most cases. While they can move their eyes in many cases, this may not be enough to signal to caregivers that they have full cognitive function. Diagnosis is often delayed because no one knows they regained awareness following an initial coma diagnosis.
Family members often recognize their loved one’s awareness and bring it to the attention of their doctor, prompting testing and diagnosis.
Treatment and Recovery After a Locked-In Syndrome Diagnosis
When a patient first comes into the hospital, the doctors must focus on identifying and treating the underlying cause of their condition. They are often in a coma and cannot breathe on their own. They may require a feeding tube and other support during the first days and weeks following their arrival.
Even once they recover consciousness and the doctor diagnoses locked-in syndrome, patients require care to sustain life and prevent further injury. This includes actions to prevent bed sores and pneumonia, as well as other infections.
Patients also need rehabilitation and various supportive therapies to allow for as much improvement as possible. Establishing communication is key for improving their quality of life, and their doctors should recommend assistive devices for communication. A power wheelchair provides the necessary mobility to participate in family and community activities.
Taking Legal Action for Your Loved One Diagnosed with Locked-In Syndrome
In some cases, people diagnosed with locked-in syndrome can pursue compensation for their treatment, rehabilitation, assistive devices, pain and suffering, and more. The attorneys from Newsome | Melton can review your case at no cost to your family. You may be able to hold the doctor responsible for a missed or delayed diagnosis. In other cases, we may be able to identify another liable party. Call (800) 917-5888 today to get started.