Richard I, Péreon Y, Guiheneu P, Nogues B, Perrouin-Verbe B, Mathe J F
Service de Rééducation Fonctionnelle, CHRU Nantes, France.
Paraplegia. 1995 Nov;33(11):640-6. doi: 10.1038/sc.1995.135.
We report 11 patients with the locked in syndrome (LIS). The functional outcome was good in four patients with notable motor recovery, but motor deficit remained seriously disturbed in seven patients. All of the patients regained some distal control of finger and toe movements, often allowing functional use of a digital switch. The independence thereby gained is worthwhile, in some patients allowing environment control, communication by means of a computer, and electric wheelchair ambulation. When motor recovery occurs, the progression is disto-proximal with dramatic axial hypotonia. In five patients clinical insomnia was noted and polysomnography showed a reduction of REM sleep. The implications of systems other than the pyramidal tracts in the physiopathology of LIS are discussed.
我们报告了11例闭锁综合征（LIS）患者。4例患者功能预后良好，有明显的运动恢复，但7例患者的运动功能仍严重受损。所有患者均恢复了对手指和脚趾运动的一些远端控制，通常能够功能性地使用数字开关。由此获得的独立性是值得的，在一些患者中可实现环境控制、通过计算机进行交流以及电动轮椅行走。当出现运动恢复时，进展是从远端到近端，伴有明显的轴性肌张力减退。5例患者出现临床失眠，多导睡眠图显示快速眼动睡眠减少。本文讨论了除锥体束外的其他系统在闭锁综合征病理生理学中的意义。
