Locked-In Syndrome: Symptoms, Recovery & Prognosis

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson is going to define locked-in syndrome, go over the three major categories of it, its signs and symptoms, as well as prognoses for survival and chances of recovery.

What is Locked-In Syndrome?

Imagine for a second that someone binds all of your legs and feet, duct tapes you thoroughly to a pole so you can't move, gags you so you can't speak, and then gives you a drug so you can't make a noise. Scary right? How would you feel? Really think about that question for a second.

A medical scenario just like this is experienced by people who have locked-in syndrome (LIS). This is a condition where a person is almost completely, or fully, unable to move any part of their body nor speak, yet is fully conscious and aware of their surroundings.

Let's go over this condition's signs, symptoms, recovery, and prognosis.

Signs & Symptoms

The Three Categories of LIS

Traditionally, LIS is subdivided into three categories. Remember, all three refer to a state where consciousness/awareness is fully intact!

  • Classical LIS refers to the inability to neither speak nor move; with the exception of blinking and vertical eye movements. The latter two motions can be used for communication so long as someone is aware that the person is performing these motions voluntarily! It should be noted that some people do have the ability to move their eyes horizontally instead of vertically.
  • Incomplete LIS refers to classical LIS but with some other voluntary movements preserved, such as some other facial movements.
  • Total LIS, where there is no mobility nor speech whatsoever.

Other signs and symptoms of LIS include any combination of the following:

  • Memory problems
  • Attention deficit problems
  • Visual difficulties but usually no difficulties with hearing
  • Insomnia, or the inability to fall or stay asleep
  • Vertigo
  • Rapidly changing emotions
  • The inability to properly swallow

Other Considerations

People who are 'locked-in' may have severe anxiety as a result of their inability to move nor speak when they clearly want to do so. Just imagine, it usually takes an average of 2.5 months to correctly diagnose LIS and differentiate it from other conditions, like a true coma! Some people had been misdiagnosed for over 5 years before someone realized they were conscious all along. They were simply assumed to be unconscious when they were not. Interestingly, it's usually family members, not physicians, who recognize signs of consciousness in a person with LIS.

Prognosis & Recovery

The prognosis for recovery from LIS all depends on exactly what caused it. In most cases, long-term survival is low. The most common cause of LIS is a vascular issue. That is to say, a blocked or burst blood vessel in the brainstem. In these instances, most people will perish within 4 months. However, those who have been medically stabilized and have survived for a year have a very good chance at living for 10 years; with many living for several decades.

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