Unlocking the Locked-In Syndrome Mystery “Sight and hearing were the only senses remaining, and they, like two solitary sparks, remained to animate the miserable body which seemed fit for nothing but the grave,” Alexandre Duma described Mr. Monsieur Noirtier de Villefort in his novel The Count of Monte Cristo in 1844 (1). This is the earliest reference known of locked-in syndrome (LIS) in literature (2). A case, which is most commonly a result of stroke, leaves its victim being fully aware and conscious yet almost completely paralyzed and immobile (3). Locked-in syndrome can be defined by how it presents itself, how it differs from other similar conditions, its various terms, and its three types. To understand locked-in syndrome, it is essential to know what it is, and what it is not. Patients with this syndrome are unable to produce speech nor movement of their volunatry muscles, however, they are aware of their surroundings, implied the National Institute of Neurological Disorders and Stroke (4). Being a fortunately-rare condition, LIS is caused by disruption of the motor tracts in the ventral brainstem, and stroke is the most common cause which holds a precentage of at least 60% of the known causes of LIS cases, as mentioned in a case report in the Journal of Pain and Symptom Management (5). The syndrome was …show more content…
LIS patients are fully awake and aware of their abnormal state and their surroundings, whereas in the cases of minimally concious state and persistent vegetative state there is partial preservation of conscious awareness or no awareness at all, respectively. To the inexperienced or quick-judging eyes, a locked-in syndrome patient would be seen equivalent to other immobile, brain-injured patients, however, the patient him or herself knows
The symptoms of a right-hemisphere stroke are very much similar like the symptoms Mr. Fix-it is experiencing. For example, both suggest that functions on the left side of the body are completely neglected; therefore, the left visual section of the body does not respond effectively to stimuli due to the neglect. Damage to the right occipital lobe is very likely. The patient may have experienced some damage to areas 18 and 19 of the occipital lobe. “Damage to these association areas resulted in the patient’s failure to recognize items even when they have been seen before”, such as Mr. Fix-it’s deficiency to recognize geometric shapes (Carlson, 2010). Moreover, the patient could have also experience damage in the frontal lobe, specifically on area 8, in which it could have r...
“Left Neglect…is a real neurological syndrome that occurs due to damage to the right hemisphere of the brain, such as might follow a right-hemisphere stroke” (Genova 323). Lisa Genova, author of “Left Neglected”, explores the bewildering neurological disorder of Left Neglect through the eyes of Sarah Nickerson. Sarah is a multi-tasking champion who holds a prestigious position as the vice president of human resources at Berkley Consulting, is a mother of three kids, and a wife to her husband Bob Nickerson, who also holds a prestigious position at another company. Life for Sarah is hectic, fast paced, and constantly moving. If it isn’t something regarding work, then it’s her children, or other priorities that seem to pile up as Sarah moves through out her life. Her fast paced life comes to a sudden halt, as one day she is apart of a severe car accident. Sarah’s next memory is waking up in the Intensive Care Unit of the hospital and learning that she has suffered an injury to her brain that has caused a condition known as Left Neglect, and this is where Sarah’s journey throughout the novel begins.
Flaccid dysarthria results from damage to the lower motor neurons (LMN) or the peripheral nervous system (Hageman, 1997). The characteristics of flaccid dysarthria generally reflect damage to cranial nerves with motor speech functions (e.g., cranial nerves IX, X, XI and XII) (Seikel, King & Drumright, 2010). Lower motor neurons connect the central nervous system to the muscle fibers; from the brainstem to the cranial nerves with motor function, or from the anterior horns of grey matter to the spinal nerves (Murdoch, 1998). If there are lesions to spinal nerves and the cranial nerves with motor speech functions, it is indicative of a lower motor neuron lesion and flaccid dysarthria. Damage to lower motor neurons that supply the speech muscles is also known as bulbar palsy (Pena-Brooks & Hedge, 2007). Potential etiologies of flaccid dysarthria include spinal cord injury, cerebrovascular accidents, tumors or traumatic brain injury (Pena-Brooks & Hedge, 2007). Possible congenital etiologies of flaccid dysarthria include Moebius syndrome and cerebral palsy. Flaccid dysarthria can also arise from infections such as polio, herpes zoster, and secondary infections to AIDS (Pena-Brooks & Hedge, 2007). Additionally, demyelinating diseases such as Guilian-Barre syndrome and myotonic muscular dystrophy can also lead to flaccid dysarthria (Pena-Brookes & Hedge, 2007). The lower motor neuron lesion results in loss of voluntary muscle control, and an inability to maintain muscle tone. Fasciculations, or twitching movements, may occur if the cell body is involved in the lesion (Seikel et. al., 2010). The primary speech characteristics of flaccid dysarthria include imprecise consonant production, hypernasal resonance, breathiness, and harsh voice (...
Imagine you are in a boring lecture and you start to drift to sleep, usually you can manage to force yourself to wake up. This may be common occurrence but try to imagine falling asleep while driving or walking. These situations seem more rare. A narcoleptic’s body doesn’t care what it is doing when it goes into these paralyzed sleeping episodes. The sudden overwhelming feeling drives the narcoleptic person to fall asleep. One type of episode that they experience is called cataplexy, which is usually caused by some stressful situation or other common activities such as laughing or running (6). During these periods the person suffers from muscle weakness and paralysis. Although the person appears to be sleeping, they are still conscious, but unable to move. They can hear and feel but cannot react to stimulation. For this reason narcolepsy is a very dangerous condition to have without receiving treatment because serious vehicle accidents can result as well as an general inability to succeed in school (6).
described in an essay called “Shaking Palsy” published in 1817 by a London Physician named
Out of mind, out of sight: A case of heminolect. In J. A. Ogden, Fractured Minds, pp. 113-117. 113-136. See also New York: Oxford University Press, 2003.
Many people have heard the term cerebral palsy and may have a personal perception of the appearance and effects of this impairment. They are (1) pyramidal system, (2) extrapyramidal system (basal ganglia), (3) extrapyramidal system (cerebellum), and (4) mixed. The Pyramidal System controls the voluntary motor movement and is especially crucial for fine motor control. Spastic (hypertonic) cerebral palsy, the most common form of cerebral palsy and is characterized by increased muscle tone that interferes with voluntary movement and fine motor movement, such as movement of the hand or fingers.
Locked-in syndrome comprises damage to the pons (located in the brainstem). From prior lectures, I assume Bauby had impairment to hubs in the brainstem central for talking and facial movements. This clarifies Bauby’s inability to freely breathe, speak, chew and swallow food and liquids. From class dialogs, we discussed how the pons has vital neural passageways amid the cerebrum, spinal cord, and cerebellum. In locked-in syndrome, I assume there has to be some disruption of the motor fibers (which control the body muscles) in the brain via the spinal cord, this explains why Bauby’s cognitive function remained intact, while his body remained
When someone is having a partial seizure they are conscious throughout the whole seizure. They know of their surroundings and remember everything that ...
Is “locked-in syndrome” a good descriptor of the experience of the author? No, the label “locked-in syndrome” is not a good descriptor of the author experience. The term “locked-in syndrome” when explained literally means that the patient is locked in his body and /or his head, but our author was able to touch the world and leave his imprints by getting his ideas and a story out of his head. With the help of his health care providers, he was able to find a way to let his readers enter his head. 4.
On December 8th, 1995 at the age of forty three Bauby had a stroke and fell into an induced coma for twenty days. After being in a coma for twenty days, Bauby awoke only to discover that his entire body was paralyzed leaving him unable to speak, eat, breath or move on his own. Bauby later found out that he had suffered from a brain stem stroke and as a result had fallen victim to a rare disorder called locked-in syndrome. Soon after Bauby discovered that he was at risk of developing an infection, in order to prevent the infection from spreading doctors had sewn Bauby’s right eyelid shut leaving him with only his left eye.
My grandfather went into the hospital with the symptoms of a stroke on Saturday, December 13, 2003. He spent the first 4 days of his stay in a coma, induced by the doctors’ misdiagnosis of his condition. My grandfather had not had a stroke, in fact he had a condition in which his liver was overloaded with toxins and was shutting down. It was a problem he’d been suffering from for quite some time; however, none of his doctors had diagnosed his symptoms correctly. The sedative they gave him upon arrival in the emergency room only worsened his condition. Upon waking up, he had to be restrained to prevent him from removing his IVs and attempting to get out of bed. He improved steadily over the next few days, and we were expecting to have him home soon. Unfortunately, he was left unrestrained one evening and was able to remove his IV, catheter, and then climb out of bed. The nurses found him on the floor of his bathroom. How long he was there, we’ll never know, because the time the nurses told us he was found, we know is not correct. He was given another dose of a sedative which caused him to be extremely disoriented the following morning, yet his old self was still shining through.
Cerebrovascular Accident a) Overview - definition and the effects of the stroke on the body A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. (http://www.nhs.uk/conditions/Stroke/Pages/Introduction.aspx) This condition is a common cause of death and disability, especially in older people. Some predisposing factors include: • hypertension • atheroma • cigarette smoking • diabetes mellitus It occurs when blood flow to the brain suddenly interrupted, causing hypoxia. The effects include paralysis of a limb or one side of the body and disturbances of speech and vision.
Hemiplegia, a condition in which one-half of a patient's body is paralyzed usually results from stroke or cerebrovascular accident. Individuals affected by hemiplegia have difficulty dealing with frustration, swallowing, walking, forming words, dressing, feeding self and bowel/urine incontinence. Quality of life from the individual’s own perspective is paramount because hemiplegia leads to self denial, self care deficit and need for minimal to total dependence. Therefore the goal of treatment is to help the individual reach his or her fullest potential for independence, functioning and accepting who they are as individuals.
The mental status exam investigates global and limbic brain functions, left and right parietal functionality and language. This is achieved through tests such as, level of consciousness, memory, and language assessment (Blumenfeld, 2010). Yanagawa and Miyawaki (2012) highlight the importance of obtaining reports from witnesses to assist with a mental status examination. They state that pre-hospital patients can deteriorate quickly into unconsciousness, limiting the ability for para...