Locked-in syndrome is the outcome when an injury to the brain stem prevents the brain from communicating with the spinal cord and the rest of the nervous system. Most commonly, this type of injury occurs because of a stroke, but it may also be the result of a traumatic brain injury. Rarely, a tumor or other medical condition can also cause this type of injury.
Locked-In Syndrome Stops Communication Between the Brain and Nervous System
Locked-in syndrome occurs most often because of damage to a key structure of the brain stem called the pons. The pons provides a pathway — a sort of communication network — for the motor fibers that connect the cerebrum and cerebellum to the spinal cord and rest of the nervous system. This damage makes it impossible for nerve signals to make it from the brain to the muscles.
This damage to the pons is not caused by locked-in syndrome. Instead, it is the cause of the patient’s paralysis and other symptoms. When a person suffers a stroke or other injury that damages the pons, one possible outcome is locked-in syndrome.
Locked-In Syndrome Leaves the Nervous System Disconnected
Locked-in syndrome is a neurological disorder that leaves a patient cognitively intact, conscious, and aware of their surroundings. However, it disconnects the spinal cord and nervous system from the signals sent by the brain. This results in near-global paralysis. Classically, those with this condition can move their eyes vertically and blink.
Some people suffer incomplete locked-in syndrome, meaning they retain additional movement in the body. When this occurs, it is a sign there are still some pathways open to connect the brain’s signals with the body’s muscles. They should receive rehabilitation that focuses on using their remaining movements and regaining movement in nearby areas of the body.
While most with classic or incomplete locked-in syndrome can learn to communicate using special eye gaze devices, some may be able to learn to breathe on their own, empty their bladder and bowels, control a motorized wheelchair, and more.
Locked-in Syndrome May Be Difficult to Diagnose Because of How It Affects the Nervous System
Because locked-in syndrome so dramatically affects the nervous system and impedes transmission of nerve impulses, patients with the condition cannot obviously signal to caregivers that they are awake and aware of their surroundings. This condition is notoriously easy to misdiagnose. In about half of all patients, it is not the doctor but a family member who first questions if the patient is conscious and cognitively intact.
A locked-in diagnosis can take weeks or months if the doctor is not proactive in checking for normal brain activity. In some cases, patients with locked-in syndrome have waited years for a caregiver or doctor to recognize the signs of locked-in syndrome.
While there is no treatment or cure for locked-in syndrome, patients who receive the right types of supportive care and who learn to communicate using vertical eye movements or blinking report a relatively high quality of life.
Ongoing Care for Patients with Locked-In Syndrome
When the doctor initially sees a patient, it is important they go to work immediately to understand what is wrong and take quick action to prevent further damage to the brain. This may include:
- Identifying and stopping a brain hemorrhage
- Administering clot-busting drugs
- Limiting swelling caused by a brain injury
- Shrinking a tumor in the brain stem
- Giving medications to prevent an overdose
The faster a doctor identifies the issue and takes action, the higher the likelihood they can prevent the type of damage that leads to locked-in syndrome or even death.
Once a patient suffers this type of damage, it is usually irreversible. While it is true that patients can regain a good quality of life despite locked-in syndrome, they will also require ongoing care for the rest of their life. Significant recovery is rare, and most who do regain some movement continue to need support from family caregivers and home health providers.
In general, those with locked-in syndrome rely on others for everything. They may need help with:
- Preventing pneumonia, urinary tract infections, and blood clots
- Regular movement to prevent pressure sores
- Physical therapy to keep joints and soft tissues in good condition
- Help to learn to communicate through eye movements
- Using eye gaze devices or other communication systems
You May Be Able to Take Legal Action After a Locked-In Diagnosis
If you or a loved one has locked-in syndrome, the attorneys from Newsome | Melton would like to review your case. Misdiagnosis and delayed diagnosis are common problems in these cases, and you may be eligible to pursue compensation if this happened to you.
You could pursue compensation to cover medical care, ongoing care costs, assistive devices, pain and suffering, and more. We can handle even the most complex cases. Call us today at (800) 917-5888 for your no-cost case evaluation.