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Written production in a case of locked-in syndrome with bilateral corticopontic degeneration.
[locked-in syndrome]
Patients
in
locked-
in
syndrome
show
normal
or
near
normal
mental
abilities
that
contrast
with
the
limited
motor
capacity
that
hinders
voluntary
communication
.
However
,
eye
movements
and
blinking
are
usually
preserved
and
can
be
used
to
establish
a
communication
system
.
We
report
an
exceptional
case
of
locked-
in
syndrome
.
The
aetiology
was
basilar
thrombosis
consecutive
to
a
cervical
manipulation
.
In
addition
,
brain
MRI
performed
23
years
later
showed
a
ventral
pontine
stroke
with
bilateral
corticopontic
degeneration
.
In
this
study
the
patient
was
able
to
produce
written
output
using
a
chin
-controlled
Morse
system
decoded
by
a
computer
.
A
detailed
linguistic
analysis
of
text
written
over
20
years
by
the
patient
was
carried
out
.
The
data
demonstrate
that
improvements
in
language
performance
can
be
observed
even
in
patients
with
brain
lesions
in
areas
associated
with
high
-level
cognitive
processes
.
The
data
show
a
decrease
of
typing
,
grammatical
and
lexical
errors
over
time
,
use
of
less
frequent
words
,
and
an
increase
of
more
complex
linguistic
structures
.
This
paper
adds
to
previous
findings
confirming
the
value
of
daily
practice
and
rehabilitation
to
enhance
quality
of
life
in
this
group
of
patients
.
