What is Locked-In Syndrome

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A complete nightmare..Have you ever been in the situation at night where you've woken up, completely paralyzed and unable to move? And shortly thereafter, arises the panic of: "What if I'm like this forever?". Then - the relief as your body starts to regain function, and you can move once more.
Locked-in syndrome - www.softwarelode.com - is when this nightmare state is permanent, and is resultant of the loss of all voluntary movement in the body except for the eyes. As a result, these people are completely unable to move their limbs (quadraplegia) and are unable to speak. They can only blink the eyes (as the system which controls the eye muscles are higher in the brainstem). One of the most disturbing manifestations of these patients are that they are conscious and completely aware, with no loss of mental processing. Depending on the extent of the area damaged, they may retain their sense of proprioception (sensing where their body lies in space) and sensation throughout their bodies.
Oddly enough, even though these patients have no paralysis of their vocal cords, they are unable to speak due to dis-coordination between their breathing and vocal movements.
How can this possibly happen? As with many bizzare neurological conditions, we turn to the blood supply of the brain to find out a little bit more.
Causes of Locked-In Syndrome
Trauma: Trauma in the area can affect the brainstem, although trauma in this area will likely cause other lasting brain injuries, such as brain damage and probable death due to loss of autonomic control of breathing.

Vascular: A major supply of blood to the brain is via the basilar artery, which is formed by the union of the two vertebral arteries. The basilar artery also gives off several pontine arteries which are important in supplying the pons. As a result if these arteries are occluded then this can result in damage to the area, which may result in locked-in syndrome.
Other less common causes include medication overdose, and damage to nervous cells (which may be caused secondary to disease).
Structures affected in Locked-In SyndromeThe most important structures which are affected in locked-in syndrome are the corticobulbar and corticospinal tracts, which are highly important in the innervation of motor nerves. As a result, the loss of these pathways means that the patient is only able to blink or move the eyes.
Due to the nature of these motor neurons lost, the patient will display signs typical of an upper motor neuron lesion, which will result in muscles been hypertonic, hyperreflexic and a positive Babinski sign where the big toe is raised (as opposed to depressed) when the sole of the foot is stimulated.
Treatment of Locked-In SyndromeAs there is no current effective method of been able to restore neurons, there is no cure at the moment. It is possible to regain some motor use through the stimulation of muscle via electrodes, but otherwise there is no treatment for this condition.
It would be best to prevent this condition from occurring in the first place. Obviously, trauma and disease are out of our control but we should do our best individually to ensure that we control as many lifestyle factors as possible to ensure that the chances of any vascular complications occurring are minimised. This should be done through regular exercise, a good diet, moderated consumption of alcohol, and not smoking (or ceasing smoking if one already does). Not only will these risk factors for heart disease prevent depression, but they will also help maintain the rest of your body.
I hope this information was some use to you! As a reminder, this information is intended as a guide only and you need to seek proper medical advice from a qualified physician if you think these issues may be affecting you.

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