Locked-In Syndrome after Trauma—A Rare Case in the Literature

Abstract

The present report is about a 25-year-old woman who had a motorcycle accident with brain trauma injury. Although she was admitted at another institution disoriented but alert, she progressively evolved to an altered level of consciousness and required orotracheal intubation. She was then transferred to our hospital sedated, and the admission head computed tomography showed signs of posterior fossa ischemia. The angiography demonstrated a vertebral artery dissection with subsequent embolization to the basilar artery, which provoked its complete occlusion. After drug withdrawal, the patient recovered level of consciousness but was aphasic and did not exhibit purpose movements apart from eye blinking, as expected in patients with locked-in syndrome.

Neuroscience of consciousness in the locked‐in syndrome: Prognostic and diagnostic review

“…When there is significant damage to the brainstem, the LIS patient will become entirely paralyzed, except for their eyes, which they may be able to open and shut at their own will. 8 The fact that many people with LIS begin in a coma or a vegetative state before recovering from it, possibly without anyone knowing as they are not able to communicate their alertness to their doctors or families, adds a layer of complexity to the challenge of getting an accurate diagnosis. 9 Although life with LIS looks dreadful, there is rising awareness of this uncommon condition.…”