Locked In: Chiropractic Adjustment Gone Wrong

Locked-in Syndrome is usually the result of quadriplegia and inability to speak in otherwise cognitively intact individuals. Those with locked-in syndrome may be able to communicate with others by coding messages by blinking or moving their eyes, which are often not affected by the paralysis. The symptoms are similar to those of sleep paralysis. Patients who have locked-in syndrome are conscious and aware with no loss of cognitive function. They can sometimes retain proprioception (a sense of where other body parts are located) and sensation throughout their body. Some patients may have the ability to move certain facial muscles, most often some or all of the extraocular eye muscles. Individuals with locked-in syndrome lack coordination between breathing and voice. This restricts them from producing voluntary sounds, even though the vocal cords themselves are not paralyzed.

Unlike persistent vegetative state, in which the upper portions of the brain are damaged and the lower portions are spared, locked-in syndrome is caused by damage to specific portions of the lower brain and brain stem with no damage to the upper brain. Possible causes of locked-in syndrome include:

  1. Traumatic brain injury
  2. Diseases of the circulatory system
  3. Medication overdose
  4. Damage to nerve cells, particularly destruction of the myelin sheath, caused by disease (e.g. central pontine myelinolysis secondary to rapid correction of hyponatremia)
  5. A stroke or brain hemorrhage, usually of the basilar artery

In the United States, there are no statistics available on how many people have locked-in syndrome but it is estimated that several thousand patients each year survive the kind of brain-stem stroke that causes the condition.

There is no standard treatment for locked-in syndrome, nor is there a cure. Stimulation of muscle reflexes with electrodes (NMES) has been known to help patients regain some muscle function. Other courses of treatment are often symptomatic. Assistive computer interface technologies, such as Dasher in combination with eye tracking may be used to help patients communicate. New direct brain interface mechanisms may provide future remedies.

It is extremely rare for any significant motor function to return. The majority of locked-in syndrome patients do not regain motor control, but devices are available to help patients communicate. Within the first four months after its onset, 90% of those with this condition die. However, some people with the condition continue to live much longer periods of time.

For more information on Locked-In Syndrome, check out our Locked-In Syndrome link.