Electrophysiological Investigations in the Locked-In Syndrome: A Case Report

• Published in: American journal of electroneurodiagnostic technology 2003-06, Vol.43 (2), p.60-69
• Main Authors: Shivji, Zaitoon M., Streletz, Leopold J., Baeesa, Saleh, Girvin, John
• Format: Article
• Language: English
• Subjects: "locked-in" syndrome; Alpha-coma; Biological and medical sciences; brainstem lesion; EEG; evoked potentials; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Medical sciences; Nervous system (semeiology, syndromes); Neurology
• ISSN: 1086-508X; 2375-8619
• DOI: 10.1080/1086508X.2003.11079421

A 17-year-old boy was involved in an accident the details of which are not well known. It was felt that he might have had some type of questionable arrest from which he was resuscitated and intubated and assessed as being in "deep coma" by the referring hospital. At our hospital, he was found to be completely unresponsive below the eyes. The only evidence of any neurological function over his body was reflex movement of the toes in plantar flexion. Caloric testing, magnetic resonance imaging (MRI), EEG, and evoked potentials (EPs) were some of the clinical investigations. MRI disclosed abnormality from the pontomedullary junction to C6-C7. This young man exhibited the features of a classic "locked-in" syndrome from a type of traumatic event, which has not previously been reported. EEG and EPs can be very important diagnostic tests in the "locked-in" syndrome, as well as providing important monitoring regarding prognosis.