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Neurorehabilitation and Neural Repair
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Long-Term Survivors of the "Locked-In" Syndrome: Patterns of Recovery and Potential for Rehabilitation

R.L. Ruff

Veterans Administration Medical Center, Case Western Reserve Medical School, Department of Neurology, Case Western Reserve Medical School

R.J. Leigh

Veterans Administration Medical Center, Case Western Reserve Medical School, Department of Neurology, Case Western Reserve Medical School

S.N. Wiener

Department of Radiology, Mt. Sinai Medical Center, Cleveland, Ohio

N.L. Adams

Veterans Administration Medical Center, Case Western Reserve Medical School

C.W. Newman

Veterans Administration Medical Center, Case Western Reserve Medical School

K.H. Nam

Veterans Administration Medical Center, Case Western Reserve Medical School

S.E. Thurston

Veterans Administration Medical Center, Case Western Reserve Medical School, Department of Neurology, Case Western Reserve Medical School

We studied four men, each of whom survived over 3 years after being "locked-in" owing to pontine infarction. Their pontine lesions were evident with magnetic resonance imaging, but not with computed tomography. All showed a characteristic pattern of recovery from the motor deficit with rapid return of eye-hand control and slow but sustained limb improvement. Despite pseudobulbar affect, all made an emotion adjustment to their severe deficits and showed a strong desire to live. Physicians should be aware of the special needs and methods for rehabilitation of patients who are clinically "locked-in."

Key Words: Locked-in • Pontine infarction • Quadriplegia • Pseudobulbar • Magnetic resonance imaging • Brainstem auditory evoked responses.

Neurorehabilitation and Neural Repair, Vol. 1, No. 1, 31-42 (1987)
DOI: 10.1177/136140968700100107
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