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Closure syndrome leads to complete physical disability, while maintaining mental fitness. It is a state in which the body is inert, and the patient knows exactly what is going on around him. What are the reasons for this condition? Are body paralysis the only symptoms of the disease? What is the treatment of people with inbound syndrome and is it possible to recover from it?

Closure team - what is it?

Closure syndrome(locked-in-syndrome orLIS ), otherwise pseudo or light coma, is rare neurological disorder , the essence of which is the complete paralysis of all muscles in the body, except those that control eye movement. The disease affects people of all ages, but most often it occurs in middle age, with a similar frequency in men and women.

The closure band started to be talked about louder when the movie "Butterfly and Suit", which is an adaptation of the book of the same title, was released. Its main character is the editor of the French edition of ELLE magazine - Jean-Dominique Bauby - who has lived with closure syndrome since a massive stroke in 1995. He died in 1997.

Closure syndrome - causes

The cause of the closure syndromeis damage to the brain stem, specifically damage to the bilateral ventral part of the bridge. This is where signals travel from the brain to the nerves to activate movement (except for the vertical movement of the eyes) and speech.

The most common causes of brainstem injury are stroke (haemorrhagic or ischemic) and mechanical injuries of the poll and upper cervical spine (this includes overly invasive procedures on the cervical spine).

Other reasons for the team shutdown are:

  • bridge hemorrhage
  • bridge abscess
  • brain-stem cancer
  • cardiovascular diseases (mainly advanced atherosclerotic lesions)
  • drug overdose
  • reaction to vaccine
  • long-term hypoglycaemia

Closure syndrome - symptoms

A person suffering fromclassic confinement syndromeremains constantly motionless due to extensive paralysis of the skeletal muscles.

However, since the ability to think or associate is not damaged (the higher structures of the brain remain fully functional), the patientis lucid and fully aware (can hear, smell, smell and touch). However, communication with him is possible only through eye movements or blinking. Due to the discoordination of breathing with the tension of the vocal cords, it is impossible to make any sounds (the patient breathes independently through the endotracheal tube).

Doctors also distinguish incomplete variants of the closure syndrome, where the patient has remnants of voluntary movement, apart from the eyelids and eyeballs.

The third variant is Total Closure Syndrome, in which patients are completely immobile (including the eyeballs and eyelids).

Closure syndrome - diagnosis

Due to the fact that it is difficult to distinguish the closure state fromthe vegetative state , brain tomography, angiography and magnetic resonance imaging are performed. Only on the basis of a detailed picture of neurological changes can the closure syndrome be diagnosed.

Closure syndrome - treatment

In the first days of the onset of the symptoms of the disease, the most important thing is to work on determining the appropriate communication code. The most frequently used method of communication is the alphabetical system: the patient indicates the selected letter with an agreed eye movement.

It is worth knowing that only some people managed to "get out" of the closure syndrome - unfortunately, causal treatment and recovery of neuromuscular function is impossible.

24/7 care is also necessary, including giving food through a tube directly into the stomach (due to swallowing disorders), administering special eye drops to prevent conjunctivitis, and other medications. It is also important to mobilize the patient to undertake broadly understood mental activity (despite the existing limitations).

Closure syndrome - prognosis

The course and prognosis are different depending on what complications occur during the course of the closure syndrome. These may be, for example: haemorrhagic duodenitis, hypertension, fever, leukocytosis, hyperplasia, changes in the blood serum lipid profile or respiratory disorders.

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Category:

Neurology