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For further information, see CMDT Part 24-23: Stupor & Coma

Key Features

  • Acute destructive lesions (eg, infarction, hemorrhage, demyelination, encephalitis) involving the ventral pons and sparing the tegmentum

  • Patient is mute and quadriparetic but conscious

  • Such a patient can mistakenly be regarded as comatose

  • Clinicians should recognize that "locked-in" individuals are fully aware of their surroundings

Clinical Findings

  • Mute, quadriplegic patient

  • Conscious state

  • Patient is capable of blinking and of voluntary eye movement in the vertical plane

  • Preserved pupillary responses to light

Diagnosis

  • Brain imaging with CT or MRI scan

  • Obtain the expertise of a clinician familiar with this disorder to aid in the diagnosis

Treatment

  • The prognosis is usually poor, but recovery has occasionally been reported, in some cases including resumption of independent daily life

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