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To the Editor.—
"Recovery from the 'Locked-in' Syndrome," the article by McCusker et al (Archives 1982; 39:145-147) stressing early supportive care, deserves further comment. I would like to call attention to the possibility of computer assistance in communication using fiberoptic sensors and audiovisual feedback, which resulted in marked clinical progress in a similar patient.
Report of a Case.—
"Locked-in" syndrome developed in a 39-year-old, previously healthy man with spontaneous midbasilar artery occlusion. He survived, but remained quadriplegic and mute, yet fully alert. He could communicate by voluntary eye opening and vertical eye movements. Effective yes or no answers to questions could be given, but this system was limited. On the 49th day he was fitted with a specially designed head harness with fiberoptic sensors attached to a microprocessor and television-computer memory board. A mastic tape was placed over the lateral border of the eye. When the light hit this material