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Varieties of the locked-in syndrome

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Summary

The locked-in syndrome (LiS) was broken down on the basis of neurological symptoms in 12 patients. The criteria of classical LiS are total immobility except for vertical eye movements and blinking. If any other movements are present one should consider the condition as incomplete LiS. Total immobility, including all eye movements, combined with signs of undisturbed cortical function in the EEG led to the concept of total LiS. The anatomical basis for this condition consists of lesions in both cerebral peduncles which interrupt the pyramidal and corticobulbar tracts, the supranuclear fibers for horizontal gaze and the postnuclear oculomotor fibers. As to the course, chronic and transient LiS have been described.

Zusammenfassung

Anhand der klinischen Symptome von 12 Patienten wurde das Locked-in-Syndrom (LiS) in das klassische LiS mit vollständiger Bewegungslosigkeit, ausgenommen vertikaler Blickbewegungen und Blinzeln, und in das inkomplette LiS mit weiteren Bewegungsresten unterteilt. Bei absoluter Immobilität mit Einschluß aller Augenbewegungen, jedoch Zeichen für ein erhaltenes Bewußtsein im EEG, wurde ein totales LiS angenommen. Die anatomische Grundlage für diese Form sind bilaterale Läsionen in den Pedunculi cerebri mit einer Unterbrechung der Pyramidenbahn, der corticobulbären Bahnen, der zentralen Fasern für horizontale Blickbewegungen und der postnukleären Oculomotorius-Fasern. Als Verlaufsvarianten wurden das chronifizierte und das transiente LiS unterschieden.

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Bauer, G., Gerstenbrand, F. & Rumpl, E. Varieties of the locked-in syndrome. J. Neurol. 221, 77–91 (1979). https://doi.org/10.1007/BF00313105

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