Syndrome of a locked person: symptoms, treatment, prognosis

Locked man syndrome is a rare neurologic disorder, which is the complete paralysis of all muscles that contract arbitrarily. Only the muscles responsible for eye movements remain unaffected. Patients with this pathology remain conscious, but lose the ability to move (not counting the eyes) and speak (aphonia). Cognitive function usually does not suffer. The patient is able to communicate with the eyes, including blinking for centuries. Violation occurs due to damage to the variolium bridge - part of the brain stem, consisting of nerve fibers responsible for transmitting information to other fragments of the brain. Since the patient appears to be in captivity with his own body, the pathology was called "locked-up syndrome".

Signs and Symptoms

People who are in the pseudocom (the second name of the disorder) are usually not able to consciously chew, swallow, breathe, talk or move. The ability to move is preserved only in eyelids and eyeballs, as a result of which patients can make vertical movements with their eyes. At the same time, movements in the horizontal plane (from side to side, not up and down) remain impossible. People in a pseudocom are bedridden and depend entirely on caregivers. Despite physical paralysis, the cognitive function of the brain remains intact.

Patients with a diagnosis of "blocked man syndrome" fully aware of everything that is happening around. They can see and hear and maintain the familiar cycles of sleep and wakefulness for the body. Communication is possible through the movements of eyeballs or blinking; Both gestures are often used. People in the pseudocom understand perfectly the meaning of everything they are told or read.

Most often, the victims are initially in a state of coma. Then gradually consciousness returns to them, however patients remain paralyzed and incapable of active life activity.

Causes

If you are interested in the syndrome of a locked person, a doctor with a specialization in neurology can tell you about the causes of this condition. Most often, it occurs as a result of damage to the variolium bridge - the storage of important neural pathways between the cerebral hemispheres, the spinal cord and the cerebellum. With this diagnosis, there is an interruption of all motor nerve fibers coming from the gray matter in the brain through the spinal cord into the muscles. The centers of the brain stem, which play a key role in the functioning of facial muscles and articulation of speech, are also damaged.

Damage to the varioly bridge, provoking the syndrome of a locked person, whose treatment is described below, can occur due to a heart attack or hemorrhage. In rare cases, a pseudocoma can be caused by a head injury.

Diagnostics

Since a neurologist can determine the syndrome of a locked person with great accuracy, diagnosis is often performed in a clinical setting. To differentiate pathology from a number of other disorders with similar symptoms, special studies are carried out. So, mandatory is MRI - magnetic resonance imaging, which is able to visually show the damage to the variolium bridge, and magnetic resonance angiography is the best way to detect blood clots in the arteries of the brain stem. In addition, these studies contribute to the detection of other brain damage.

The electroencephalogram, which is a method of measuring the electrical activity of the brain, can prove the fact of normal brain activity and the preservation of sleep and wake cycles in patients diagnosed with a "locked-up syndrome".

Treatment

Any treatment should primarily be aimed at eliminating the cause of the pathology. For example, the removal of a blood clot (thrombus) in the basilar artery by intraarterial thrombolytic therapy can be performed within the first six hours after the appearance of a typical symptomatology.

Often in the first months of pseudocoma patients need special equipment to ensure continuous breathing. In most cases, a tracheotomy is performed - a tracheal opening, after which a tube is inserted into the respiratory tract to ensure a direct intake of air into the lungs.

The use of food and drink through the mouth is impossible, because it can cause respiratory infections due to food ingested into the lungs instead of the stomach. Therefore, it may be necessary to perform one more operation - gastrostomy, in which an artificial lumen is made in the stomach to introduce food and water through the tube.

Contact

It is important to invent a system of communication with the victim as soon as possible. Persons caring for the patient, as well as relatives and friends, should try to establish contact as soon as possible in order to find out in time all the needs of the bedridden patient. Unfortunately, with the diagnosis of "locked-up man syndrome", the prognosis is extremely disappointing: this condition can not be cured, although in some cases over time people are able to gradually reduce facial muscles. Modern technology is developing very quickly - it is quite possible that soon scientists will invent a computerized method of communicating with people who have fallen into the pseudo.

Since computerization has not yet made such progress, in each individual case it is necessary to develop its own system of contacting the patient. It is recommended to begin with the simplest coding: for example, looking up will mean a statement or agreement, a look down is disagreement or denial. In a condition such as the syndrome of a locked person, rehabilitation begins with a small one, but gradually, more complex codes transmitted by eye movements can be used in communication. The use of the alphabet is also possible; Often relatives distribute vowels and consonants in separate columns and wait until the patient "calls" a glance at first the column and only then - a specific letter. It is known that individual persons, despite being in a pseudocom, wrote poems in this way.

To live on

It must be remembered that the syndrome of a locked person is in no way a verdict. With due care from relatives, friends or hospital staff and quality technical support, even with such a diagnosis, a patient can lead a decent life.