Locked-In Syndrome: Three Cases Report

Yıl 2010, Cilt: 12 Sayı: 2, 54 - 57, 01.07.2010

Ertuğrul Uzar Mustafa Yılmaz Hasan Rıfat Koyuncuoğlu Serkan Kılbaş

Öz

Locked-in syndrome is rare. The clinical criteria of complete locked-in syndrome are tetraplegiaand paralysis of cranial nerves except vertical eye movements and preserved consciousness.The most common lesion underlying the locked-in syndrome is a thrombosis of the basilar arteryand as well as an almost total pontine infarction was demonstrated on CT-and MRI-scans.Intravenous and intra arterial thrombolysis have been used successfully in a selective group ofpatients with ischemic stroke. Intensive and early rehabilitation improved the functional recoveryand reduced the mortality rate. Commonly leads to death, frequently due to pneumonia. In thisreport we present cases with locked-in syndrome that were followed up in our clinic

Anahtar Kelimeler

Locked-in syndrome, thrombosis, prognosis

Locked-In Sendromu: Üç Olgu Sunumu

Öz

Locked-in sendromu nadir görülmektedir. Komple formunun klinik kriterleri tetrapleji vebilincin korunduğu vertikal göz hareketleri dışındaki kranyal sinir paralizileridir. Locked-insendromunun altında yatan en sık lezyon baziler arterin trombozudur ve buna bağlı gelişen totalpontin infarkt tomografi ve manyetik rezonans görüntüleme ile gösterilmiştir. İntravenöz veintra-arterial trombolizis iskemik stroklu seçilmiş grup hastalarda başarıyla kullanılmıştır. Yoğunve erken rehabilitasyon fonksiyonel iyileşmeyi artırır ve mortalite oranını düşürür. En sık ölümnedeni pnömonidir. Burada kliniğimizde takip ettiğimiz locked-in sendromlu üç hastayı sunduk

Anahtar Kelimeler

Locked-in sendromu, tromboz, prognoz

Kaynakça

• Kransnianski M, Gaul C, Neudecker S, Behrmann C, Schlüter A, Winterholler M: Yawning despite trismus in a patient with locked-in syndrome caused by a thrombosed megadolichobasilar artery. Clinical Neurology and Neurosurgery.106:44-46, 2003.
• Gilroy J.( çeviri Karabudak R): Locked-in Sendromu. Temel nöroloji. 270, 2002
• Mellado P, Sandoval P, Tevah J, Huete I, Castillo L: Intra- arterial thrombolysis in locked-in syndrome. Report of two cases:Rev Med Chil. 132 (3):357-60, 2004
• Casanova E, Lazzari RE, Lotta S, Mazzucchi A: Locked-in syndrome:improvement in the prognosis after an early intensive multidisciplinary rehabilitation. Archives of physical medicine and rehabilitation. 84(6):862-867, 2003.
• Ockey RR, Mowry D, Varghese G: Use of Sinemet in locked- in syndrome: a report of two cases. Arch Phys Med Rehabil. 76(9):868-70, 1995.
• Ebinger G, Huyghens L, Corne L, Aelbrecht W: Reversible ‘’locked-in’’ syndromes. Intensive Care Med. 11(4):218-9, 1985.
• Budak F, Ilhan A, Ozmenoglu M, Komsuoglu SS: Locked-in syndrome: a case report. Clin Electroencephalogr. 25(1):40-3, 1994.
• Breen P, Hannon V: Locked-in syndrome: a catastrophic complication after surgery. Br J Anaesth. 92(2):286-8, 2004.
• Patterson JR, Grabosis M: Locked-in syndrome: a review of 139 cases. Stroke. 17:758-764,2005.