Posted on March 24, 2008 · Posted in Brain Injury

In yesterday’s blog, I talked about the exception to my skepticism about miracle recoveries, years post a coma causing event. The exception is in the cases of “locked in syndrome”. The National Institute of Health contains this definition of Locked-Iin Syndrome:

What is Locked-In Syndrome?_Locked-in syndrome is a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movements
Is there any treatment?

There is no cure for locked-in syndrome, nor is there a standard course of treatment. A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, may help activate some paralyzed muscles. Several devices to help communication are available. Other treatment is symptomatic and supportive.
What is the prognosis?

While in rare cases some patients may regain certain functions, the chances for motor recovery are very limited.
What research is being done?

The NINDS supports research on neurological disorders that can cause locked-in syndrome. The goals of this research are to find ways to prevent, treat, and cure these disorders.


Why do I feel that locked-in syndrome is an exception to the no hope scenario in long term coma recovery? Because these are cases where the person was fully aware, despite the inability to communicate. What is so tragic when such cases are discovered after the fact, is that the person was there, so to speak, the whole time, just no one was listening. If a PET scan or fMRI had been done, it would have been clear from the beginning that such person’s brain was functioning. Instead, like the character in the anti-war story that galvanized my youth, Johnny Got His Gun, the mind of the survivor was totally isolated.

Another interesting example of a locked in type syndrome is the House episode where it begins with the seemingly persistent vegetative individual driving his wheel chair into a swimming pool.

See also:

About the Author

Attorney Gordon S. Johnson, Jr.
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice :: 800-992-9447