ArticleLocked-in syndrome: improvement in the prognosis after an early intensive multidisciplinary rehabilitation1
Section snippets
Participants
From 1995 until 2001, 14 patients with LIS, at different times and at different periods after the morbid event, were hospitalized in the 3 participating centers and selected for this study. The follow-up has continued for a range of time between 5 months and 6 years—at the beginning during the hospitalization and subsequently by telephone contact.
We decided not to establish a control group, for ethical reasons and because of the rarity of LIS. Hence, all patients with LIS were admitted to the
Results
The subjects with LIS were 9 men and 5 women (table 3); their mean age at onset was 44.7 years (range, 16–71y). The etiology was vascular in 11 cases and traumatic in the remaining 3 cases. Disorders of protein S, unknown before the illness, were found in 2 patients, and intake of drugs, such as hormone, was discovered in the history of 2 others. Moreover, before the onset of LIS, 1 patient was positive for HIV (human immunodeficiency virus) and 2 others had a diagnosis of hypertension.
Discussion
The population with LIS analyzed in our 3 centers does not appear substantially dissimilar from patients with LIS described elsewhere in the literature. In fact, in our population, the mean age at onset was 44.7 years; 9 were men (64%) and 5 (35%) women, and the etiology was vascular in 11 cases (78%) and traumatic in 3 (21%). In Patterson and Grabois’s literature review,4 the mean age of patients with LIS was 52 years, 85 (62%) were men and 52 (38%) were women, and the most common etiologic
Conclusions
After studying a consecutive sample of 14 patients with LIS hospitalized in our centers, and after comparing our results with the data reported in the literature, it seems that an intensive and early multidisciplinary rehabilitative treatment, begun, when possible, within about 1 month of the onset of the morbid event, improved health status at follow-up and reduced the mortality rate below 60%, as reported by several researchers about 10 years ago. In addition, in our case series, the recovery
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