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Clinical characteristics and outcome in the acute phase of ischemic locked-in syndrome: case series of twenty patients with ischemic LIS.
[locked-in syndrome]
Locked-
in
syndrome
(
LIS
)
is
a
condition
characterized
by
quadriplegia
and
anarthria
.
The
most
common
cause
is
a
ventral
pontine
lesion
due
to
atherosclerotic
basilar
artery
disease
.
Cases
with
LIS
were
prospectively
identified
among
the
patients
with
acute
ischemic
stroke
over
3
years
,
between
2009
and
2011
.
Clinical
characteristics
,
topographic
localization
of
lesions
,
and
outcome
were
determined
during
the
first
6
months
from
onset
of
LIS
.
O
ur
case
series
consists
of
20
patients
(
mean
age
62
±
10
years
;
range
46
-
82
)
.
Initially
16
patients
had
a
reduced
level
of
consciousness
(
mean
3
days
;
range
1
-
15
)
.
Respiratory
disturbance
,
mainly
as
impairment
of
the
breathing
pattern
,
was
noted
in
all
cases
.
Five
patients
died
within
the
first
10
days
due
to
stroke
progression
or
cardiac
arrest
.
In
the
remaining
cases
the
most
frequent
causes
of
death
were
pulmonary
infections
and
sepsis
.
Overall
mortality
in
the
acute
phase
of
LIS
is
75
%
,
and
the
median
survival
time
is
42
days
.
There
was
a
statistically
significant
association
between
the
more
extensive
parenchymal
brain
stem
lesions
and
observed
mortality
.
Ischemic
LIS
is
commonly
caused
by
an
acute
complete
occlusion
of
the
basilar
artery
due
to
atherosclerotic
lesions
in
intracranial
vertebrobasilar
vessels
.
Mortality
remains
high
in
the
acute
phase
of
the
disease
.
Diseases
Validation
Diseases presenting
"intracranial vertebrobasilar vessels"
symptom
locked-in syndrome
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