Locked-in Syndrome

Jim Zisfein jzisfeinNOjzSPAM at excite.com.invalid
Sun Jun 18 21:15:26 EST 2000


Marco de Innocentis <mdeinnocentisNOmdSPAM at hotmail.com.invalid>
wrote:
>I have recently been reading a lot on the so-called locked-in
>syndrome, where following a stroke in the brain stem a person
>is often left completely paralised except for one or both eyes.
>Why are the eyes usually spared from the overall paralysis?
>Are there any reported cases in which a person is 100%
>paralised but there is still normal brain activity?

The locked-in syndrome occurs with some lesions in the pons.
Vertical movements in the eyes are spared because those
movements are coordinated from the midbrain, not the pons. The
midbrain also mediates consciousness.

Some patients who are unconscious and paralyzed from a brainstem
lesion have a superficially normal-looking EEG with alpha
rhythms, but without reactivity to external stimuli. There are
none reported with "normal brain activity".

-Jim

James Zisfein, M.D.
Section Chief of Neurology
Lincoln Hospital, Bronx, NY

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