“The locked-in syndrome”: Can it be unlocked?

Locked-in syndrome is one of the most disabling states characterized by the preservation of conscious mind within a quadriplegic and anarthric body. Recently, there has been increased public awareness about this rare condition, and more cases are reported. The commonest causative lesion is bilateral ventral pontine damage secondary to vertebrobasilar artery occlusion. Clinicians need to be familiar with the condition because there is a high chance of erroneous diagnosis, such as coma or vegetative state, after a prolonged unconscious state. It is often the relatives or carers who recognize the conscious state first and report that the patient can communicate through his eyes. Because of complications, such as aspiration and sepsis, about 40–70% of sufferers die in acute phase of illness. However, advancements in medical care, rehabilitation, and communication technology have enabled many chronic locked-in syndrome patients to lead meaningful lives in the society with the help of family and friends.