China
Africa
Explore chapters and articles related to this topic
Locked-In Syndrome
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
The pattern of symptoms described above is considered classical locked-in syndrome. However, there are also cases where touch and hearing sensations are partially or completely lost, and cases in which movement of the eyes is completely lost (Patterson & Grabois, 1986). The reason that there is variation is due to the extent of the brain damage in each individual person, because the nerve fibers for all of those things are located close together.
The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
The American director, Julian Schnabel, appropriately decided to make the movie in French. In an interview with Charlie Rose,63 Schnabel explained that he made the movie after his father died, as a self-help device to help himself deal with his own inevitable death. The film is accurate and unique in showing what Jean-Dominique would have seen in this condition. On the screen, Jean-Dominique’s visual field is shown through the lens of the camera. Blinking is imitated by having the cinematographer move objects in front of the camera. His thoughts are the main narrative in the film. The camera shows double vision, difficulty focusing, and a constricted keyhole visual field, which would be quite correct if—in the setting of a basilar artery occlusion—the posterior occipital fields were involved. It also mostly shows his limited eye movements, although the camera does move vertically and horizontally and scans the room. (In locked-in syndrome, only vertical eye movements are possible, which then produce double vision.) Nonetheless, it remains highly speculative what patients see and notice in the acute phase. The rehabilitation and extreme effort of a speech therapist to communicate with him are notable and mostly correct. Standard orientation questions are asked (“Are we in Paris?” and “Does wood float?”). In patients with locked-in syndrome, establishing communication is, however, far more difficult in the early post-stroke phase, although later computer-assisted communication can be very effective.64
Treatment at the Raphael Hospital
Published in Barbara A. Wilson, Allen Paul, Rose Anita, Kubickova Veronika, Locked-In Syndrome after Brain Damage, 2018
Barbara A. Wilson, Allen Paul, Rose Anita, Kubickova Veronika
On ITU a lumbar puncture was performed, which came back as NAD except for a slightly raised protein. Overnight he was kept sedated and ventilated. The following morning the team attempted to wake him with a view to extubate as his examination and bloods were pristine. Unfortunately, he did not seem to be able to move, although he was alert and moving his eyes. His cough reflex, which had been previously present, was lost. His neurology at this time was of widespread flaccid paralysis, reduced reflexes (especially on the right), equivocal plantars and no gag reflex. A second CT angiogram was completed after consultation with the neurologists, which showed an occluded basilar artery as far as its termination, with otherwise unremarkable vasculature. There was also low attenuation in the cerebellar hemispheres. A diagnosis of Locked-In Syndrome was made.
Management of communication disability in the first 90 days after stroke: a scoping review
Published in Disability and Rehabilitation, 2022
Caroline Baker, Abby M. Foster, Sarah D’Souza, Erin Godecke, Ciara Shiggins, Edwina Lamborn, Lucette Lanyon, Ian Kneebone, Miranda L. Rose
This review aimed to include evidence that addressed all types of neurogenic communication disabilities as a consequence of stroke. However, the vast majority of eligible studies addressed either assessment, treatment, or management approaches of one specific communication disability after stroke: aphasia (103/129). Far fewer studies were identified that focused on the management of other neurogenic communication disabilities, such as dysarthria (3/129), cognitive-communication disability (8/129), and sensory loss post-stroke (4/129). Only one study focused on the management of the locked-in syndrome. Two studies focused on apraxia of speech. The variation of diagnostic criteria in apraxia of speech, and common co-morbidity with aphasia, is likely to contribute to the challenges of research and clinical practice management after stroke [167].
The role of the interdisciplinary team in subacute rehabilitation for central pontine myelinolysis
Published in Disability and Rehabilitation, 2020
Katelyn Fuller, Camilla Guerrero, Maybel Kyin, Cathelyn Timple, Marie Yeseta
Typically, patients show other neurological manifestations, such as encephalopathy and seizures, caused by the metabolic disturbances that later originate CPM, presenting in the form of a brainstem dysfunction and evolving bilateral hemiparesis [1,3,4]. The most severe cases may present with locked-in syndrome, a condition coined by Plum and Poser in 1966 which is defined as a state of wakefulness with detectable awareness within a non-functional body [5]. Although the exact pathogenesis is still unknown, conditions predisposing patients to CPM include alcoholism, liver disease, and malnutrition [2,4]. CPM has been closely correlated with rapid correction of chronic hyponatremia and current theories suggest that there are long-term alterations in the metabolic balance within the body that may trigger a cellular cascade resulting in CPM with acute adjustments in sodium levels [1,4,6–9].
A qualitative study adopting a user-centered approach to design and validate a brain computer interface for cognitive rehabilitation for people with brain injury
Published in Assistive Technology, 2018
Suzanne Martin, Elaine Armstrong, Eileen Thomson, Eloisa Vargiu, Marc Solà, Stefan Dauwalder, Felip Miralles, Jean Daly Lynn
This phase focused on the evaluation of efficacy and stability of the system. The two selected cognitive rehabilitation tasks that emerged from Phase 2 were evaluated by a control group and by end users with TBI. Ten people were recruited to evaluate the tasks: five participants (four female, M = 36.6 years, ±9.3) in a control group, and five target end users (one female, M = 37 years, ±8.7) living with TBI (Post-TBI M = 9.8 years, ±3.7). Both groups completed the two integrated tasks at the easiest level of complexity on three separate occasions each. The target end users had a diagnosis of moderate to severe BI, were medically stable, and had no history of epilepsy in the last year or post-rehabilitation. Individuals’ cognitive and physical impairment varied; however, each participant was able understand the study, give consent, and learn to interact with the BCI. No individual was living with locked-in syndrome at the time of testing; however, three participants lived experience of locked-in syndrome immediately after TBI for a period of time. All participants were ambulant, with different degrees of competency.