Sunnaas Rehabilitation Hospital and Faculty of Medicine, University of Oslo, Norway.
Acta Neurol Scand. 2012 Mar;125(3):192-8. doi: 10.1111/j.1600-0404.2011.01552.x. Epub 2011 Jun 28.
A stroke that affects the medulla oblongata and/or pons can result in tetra pareses and paralysis of the lower cranial nerves while other parts of the brain remain intact, thus locking the person in. The incidence and prevalence is not known. The aim of this article is to communicate the need for and benefits of a comprehensive rehabilitation and a standardized way of approaching the locked-in person.
To illustrate the rehabilitation process, we present four cases to highlight the needs of the person and what is required of the team.
Communication at arrival: three persons communicated through eye movement, one by weak voice. At follow-up (1-6 years later): computer assisted communication was used by two persons, a letter board by one and 'ordinary communication' by one.
There is a need for follow-up not only to re-assess skills and needs partly owing to new technologies but also to see whether the person needs more assistance to adapt to the alternative means of communication or whether the carers of the person need extra information about communication. We conclude that the low incidence of the syndrome necessitates a skilled team in which different professionals can together assess the person. This probably requires some centralization.
延髓和/或脑桥的卒中可导致四肢瘫痪和颅神经麻痹，而大脑的其他部分保持完整，从而将人锁定在这种状态。其发病率和患病率尚不清楚。本文旨在强调对闭锁综合征患者进行全面康复和标准化治疗的必要性和益处。
为了说明康复过程，我们介绍了四个病例，突出了患者的需求和团队所需的条件。
入院时的交流：三个人通过眼球运动进行交流，一个人通过微弱的声音进行交流。随访（1-6 年后）：两个人使用计算机辅助交流，一个人使用字母板，一个人使用“普通交流”。
需要进行随访，不仅要重新评估技能和需求，部分原因是新技术的出现，还要观察患者是否需要更多的帮助来适应替代的交流方式，或者患者的照顾者是否需要更多关于交流的信息。我们的结论是，该综合征的发病率低，需要一个由不同专业人员组成的熟练团队，共同评估患者。这可能需要一定程度的集中化。
