Q&A: What is locked-in syndrome?

Patients are aware of what is happening but cannot move due to almost total paralysis

There is no known cure for locked-in syndrome. There are some very limited treatments, including ones which use electrodes to stimulate muscle reflexes. These have been shown to activate some paralysed muscles, although the success rate is very low. File photograph: Getty Images

There is no known cure for locked-in syndrome. There are some very limited treatments, including ones which use electrodes to stimulate muscle reflexes. These have been shown to activate some paralysed muscles, although the success rate is very low. File photograph: Getty Images

 

What is locked-in syndrome?

Put very simply, patients who develop this syndrome are aware of what is happening around them and have full cognitive function, but they cannot move or speak as a result of almost total muscular paralysis. Generally speaking, the only muscles which retain movement are around the eyes. It is an extremely rare condition.

What causes it?

There are multiple causes. In the case of Eoin O’Mahony, the syndrome developed after he complained of headaches and underwent two brain procedures, which included the partial removal of a tumour. After the procedures he lapsed into a coma and sustained devastating brain injuries. The syndrome can also be caused in certain cases by strokes, medication overdoses and brain haemorrhages.

How is it distinguished from other comas?

After patients with locked-in syndrome suffer a catastrophic brain injury, they can remain comatose for weeks or even longer. Very gradually they wake up and their cognitive function returns. However, they cannot move as all their muscles are paralysed and to a casual observer they look to be in a persistent vegetative state. In a great many cases, it is family members rather than medical professionals who first detect the cognitive function in a patient with the syndrome.

Can it be cured or treated?

There is no known cure for the condition. There are some very limited treatments, including ones which use electrodes to stimulate muscle reflexes. These have been shown to activate some paralysed muscles, although the success rate is very low.

Can those with the syndrome communicate?

Patients can sometimes use computer technology to communicate. The technology relies on eye-tracking to make communication possible, although it is by its very nature extremely limited.

Do patients ever recover?

There have been recorded cases of people who have been diagnosed with locked-in recovering motor function, although it is extremely rare and medical science has struggled to explain it.

What is the life expectancy of someone diagnosed with the condition?

As long as a patient is stable and in receipt of the medical care they require, life expectancy can extend into decades. While the chances of recovery are very slight at present, eye-controlled, computer-based communication technology and synthesised speech are always advancing, as is medical knowledge.

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