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Editorial
October 2013

Locked-In or Locked-Out, But Present

Author Affiliations
  • 1From the Department of Neurology, University of Florida College of Medicine and the Malcom Randall Veteran’s Affairs Hospital, Gainesville, Florida
JAMA Neurol. 2013;70(10):1229-1230. doi:10.1001/jamaneurol.2013.3694

In their classic book Plum and Posner1 used the term locked in syndrome for patients who had an injury (eg, stroke) to the brainstem that induced quadriplegia as well as a bulbar and pseudobulbar paralysis of the cranial nerves, but sparing the oculomotor nerve. Patients with this disorder can be alert, aware of some forms of stimuli, and can communicate by using vertical eye movements and blinking. Thus, these patients actually have a partial locked-in syndrome.

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