J Korean Neurosurg Soc.
1977 Dec;6(2):533-536.
A Case of Cerebromedullospinal Disconnection: The 'Locked-In' Syndrome
- Affiliations
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- 1Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
Abstract
- The 'Locked-In' syndrome, first described by plum and posner in 1966 as a brain stem stroke due to bilateral basis pontis infarction with limb and psedobullar paralysis, but with unimpaired consciousness communicating intelligently by vertical eye movement had become contradistinctive to the state of 'akinetic mutism', coined by Cairns er al in 1941, which can be described as unresponsive patients who appear to be awake but are not aware of the environment, lacking response to command but having the ability to move his extremities. Recently there has been interest in this disorder, both pathologically and clinically with regard to its anatomical location of the lesion at various levels of the brain stem and its clinical characteristics including the ocular signs, the electroencephalogram, the outcome of the disorder etc., respectively. We have experienced a case of brain stem stroke that was compatible with the 'Locked-In' syndrome, determined by clinical evaluation alone. Postmortem examination was not granted. A brief review of the literatures is added and the difference between the 'Locked-In' syndrome and cliassical akinetic mutism is discussed, also stressing differentiation of the Locked-In patient from the comatose patient.
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