locked-in syndrome

Etiology

• lesions involving the ventral pons bilaterally
• basilar artery thrombosis or embolism

Clinical manifestations

• quadriplegia
• loss of lower cranial nerve function
• wakefulness & awareness of the environment
• vertical eye movements & blinking are often preserved
  • may be only mechanism for patient to communicate with the outside world
• preserved tendon reflexes
• Babinski's sign
• abnormal pupillary reflexes

Laboratory

• electroencephalography (EEG) is often normal

Differential diagnosis

• cataplexy

More general terms

• disease/disorder primarily affecting brain
• syndrome