Trapped: Locked-In Syndrome (Spotlight Series #1)

By Afan Atif

Everybody has felt trapped before—whether it be a child locked in a car on a hot day or a bird confined inside a cage. In some cases, a person can be imprisoned within their own mind.

Unfortunately, to sufferers, this ‘jail’ is known as Locked-In Syndrome (LIS). They are often diagnosed as comatose but are afflicted by a much worse fate. The symptoms of LIS inhibit nearly all functions and destroy the ‘prisoner’s’ way of life. The affected structure, the pons, is responsible for breathing and sensory interaction. As one would predict, damage to this critical structure would affect most senses. The corticospinal tract is located on the pons. Damage to this motor pathway will cause quadriplegia—the paralysis of limbs. Furthermore, the corticobulbar tracts are also located in the pons. Damage to this results in no facial movement. LIS also causes aphonia—the loss of the ability to speak. An LIS patient has almost no way to connect with others. The only way one can communicate is through woeful eye movements. Unlike a vegetative state, the person retains all consciousness. Essentially, the person is able to think without any expression.

Locked-in Syndrome (LIS) has a variety of causes ranging from specific poisons to severe trauma. For example, in rare cases, snake venom can cause LIS. The patient returns to full function once an anti-venom is administered. Additionally, poison from the curare plant—a plant originating in Central and South America—can also cause LIS. Unfortunately, there is a  permanent condition caused by lesions on the pons and brain hemorrhages. Aneurysms and overdoses can also cause permanent damage. As a result, doctors are uncertain in diagnosing this condition. On average, initial diagnoses take 2.5 months, but some diagnoses have taken over 5 years.This is truly horrific. The timespan of diagnostics can be horrific, and the patient’s life may have already ended before the diagnosis is complete.

The future is bleak for these patients. Motor functions are rarely recovered. Surprisingly, medical professionals suggest euthanasia instead of treatment. Many patients are often unable to breathe, and a tube for breathing must be placed in the throat. Furthermore, eating and drinking tubes are a necessity. However, researchers have worked to improve the lives of these patients. Eye-controlled interfaces allow patients to answer ‘yes’ or ‘no’ questions. Word processors and speech synthesizers further facilitate communication. Current technology even allows these patients to access the internet because the language abilities of the patients are usually intact. These treatments can only improve the quality of life for patients with LIS.

LIS  can be mitigated through regular rehabilitation. Through rehabilitation, patients are able to breathe and eat on their own. Eventually, their limited motor function can be recovered, allowing for the operation of a wheelchair. Through modern medicine, the once dismal outlook on these patients continues to transform.

Vivian Lu