Delacour J L, Floriot C, Wagschal G, Ritz A, Faller J P, Daoudal P, Noirot A
Service de Réanimation Polyvalente, Centre Hospitalier Paul-Morel, Vesoul.
Ann Fr Anesth Reanim. 1988;7(5):433-6. doi: 10.1016/S0750-7658(88)80065-0.
The locked-in syndrome is poorly understood, and may be misdiagnosed as coma. The syndrome consists of complete paralysis of all four limbs and the lower cranial nerve pairs, associated with an unaltered consciousness. Vertical eye movements and blinking remain intact, so allowing some form of communication by way of eye codes. Obstruction of the vertebral and basilar vascular system is the major cause, but the six cases reported show the aetiological diversity of this syndrome. If the vascular obstruction is diagnosed within the first few hours, fibrinolytic therapy may be considered. Although the patients usually die within a few days or after several months, some rare cases of recovery after several weeks have been reported. Intensive care is required by these patients (tracheostomy, artificial ventilation, intensive nursing care); the physicians and nursing staff looking after them should always keep in mind that these patients are conscious and able to communicate.
闭锁综合征鲜为人知，可能被误诊为昏迷。该综合征表现为四肢和较低位的脑神经对完全麻痹，意识却未改变。垂直眼球运动和眨眼功能仍保留，因此可通过眼神编码进行某种形式的交流。椎基底血管系统阻塞是主要病因，但所报告的6例病例显示了该综合征病因的多样性。如果在最初数小时内诊断出血管阻塞，可考虑进行纤溶治疗。虽然患者通常在数天内或数月后死亡，但也有报道称少数病例在数周后康复。这些患者需要重症监护（气管切开术、人工通气、重症护理）；照料他们的医生和护理人员应始终牢记，这些患者意识清醒且能够交流。
