Locked in Syndrome

A rare condition characterised by flaccid paralysis from the neck down, accompanied by facial paralysis, anarthria, and aphonia. Locked-in syndrome is caused by severe damage to the brain stem, dysfunction of descending motor pathways or peripheral nerves, 2º to bilateral destruction of the basis pontis or medulla and sparing of tegmentum, caused by infarcts or central pontine myelinolysis. Locked-in syndrome patients are conscious and alert, but only capable of communicating by moving their eyes—voluntary eye movement—and eyelids—blinking