Locked-in Syndrome
| Classification according to ICD-10 | |
|---|---|
| G83.5 | Locked-in Syndrome |
| P91.80 | Locked-in syndrome in the newborn |
| ICD-10 online (WHO version 2019) | |
The locked-in syndrome (engl. .; dt Eingeschlossensein- or entrapment syndrome ) is a condition in which a person while in consciousness , but physically almost completely paralyzed and unable is to verbally or by movements to make themselves understood.
Opportunities for communicating with the outside world usually only result from the preserved vertical eye mobility, and if this has also been lost, from a measurement of the pupil dilation. The use of a brain-computer interface is another way of enabling the person concerned to communicate with the outside world. The sense of hearing is completely intact. Some sufferers can answer questions that can be answered with “yes” or “no” by moving their eyes or winking. If there is no voluntary muscle activity at all, one speaks of the completely locked-in syndrome ( completely locked-in syndrome , CLIS).
causes
The neurological causes of locked-in syndrome include lesions in the pons , rarely also in the midbrain or on both sides of the internal capsule . The lesions are generally caused by a vascular disorder following a thrombosis of the basilar artery . It is difficult to distinguish this form of locked-in syndrome from other forms of paraplegia with loss of consciousness . Due to the damage in the area of the pons, vertical eye movements are possible, since the motor areas, in contrast to the horizontal movements, are above the pons. Communication is possible with the help of these eye movements.
Care of those affected
The care requires special care measures . A treatment of causes psycho- and physiotherapy and occupational therapy for the promotion of self-employment are necessary. Usually the patient has to be fed artificially because of the swallowing disorder ( dysphagia ) . The ability to swallow and the ability to speak are partially or sometimes completely restored by means of speech therapy . The disease is serious and has a significant mortality rate . An at least partial improvement of the condition is possible.
One affected person reported:
“I believe that the infinite patience that the treatment of my illness needs is not very common in our society and that my illness and this fast-paced society have nothing in common. Certainly what I fear most is impatience. It seems as if people have forgotten that it took them about a year to learn to walk and speak ... I will certainly need at least as long under difficult conditions. "
According to studies with locked-in patients suffering from ALS, the majority of them describe their quality of life as "'satisfactory' or even 'good'", whereby communication skills and interaction with the environment are of great importance.
Differentiation from the vegetative state
The locked-in syndrome is the vegetative state delineate, as the awareness of the patient remains largely intact. He is usually just as receptive as a healthy person. He can hear and understand everything around him, but cannot communicate in a conventional way.
See also
Individual evidence
- ↑ Locked-in syndrome: pupils say “yes” and “no”. In: Pharmaceutical newspaper. August 6, 2013, archived from the original on October 14, 2013 ; Retrieved August 7, 2013 .
- ^ A b Joseph Claßen, Alfons Schnitzler (ed.): Interventional Neurophysiology: Basics and therapeutic applications . Georg Thieme Verlag, 2012, ISBN 978-3-13-169871-1 , p. 291 ( google.de ).
- ↑ S. Laureys et al. : The locked-in syndrome: what is it like to be conscious but paralyzed and voiceless? In: S. Laureys (Ed.): Progress in Brain Research . tape 150 . Elsevier, ISSN 0079-6123 , chap. 34 , p. 495 , doi : 10.1016 / S0079-6123 (05) 50034-7 (English).
