Symptoms
The symptoms that occur in Locked-In-Syndrome restrict the patient’s life in the most massive way. The affected person is not able to control his or her voluntary musculature. The paralysis affects not only the limbs, back, chest and stomach, but also the neck, throat and facial muscles.
Neither speaking nor swallowing is actively possible. The patient therefore usually has to be artificially fed. Almost all eye muscles are also affected by the paralysis, only vertical eye movement is possible, which can be used as a means of communication.
The patient is not at all or hardly restricted in thinking and consciousness and perceives his environment completely. For the affected person, this means a great deal of suffering, because although he is fully aware of his environment, he cannot interact with it. The patient is helplessly exposed to the situation. As a result of this condition, psychiatric secondary diseases, such as depression, are not uncommon.
Therapy
Intensive care and comprehensive nursing measures can improve the symptoms. First, the cause of the brain damage must be eliminated as far as possible. Then the brain‘s ability to reconnect nerve cells and thus restore the functionality of various nerve cords must be relied upon to a large extent.
The various therapists must work closely together on this. Speech therapists train speech with the patient, physiotherapists try to maintain mobility and slowly allow the patient to make their own movements. The comprehensive therapy concept used to improve the condition of Locked-in-Syndrome also includes psychotherapy and occupational therapy. With a lot of patience and work, a far-reaching reduction of the symptoms is possible, but cannot be promised. So far, there is no drug or surgical therapy option.
Care
Caring for a person suffering from locked-in syndrome is extremely time-consuming. Due to the holistic paralysis, all hygiene measures must be taken over at least at the beginning of his recovery phase.Since a normal toilet visit is not possible and no button can be pressed, a supply of diapers is usually started, which can be replaced by a bedpan during the healing process. Due to the paralysis of the throat and pharynx muscles, further problems in care occur.
The patient has lost the ability to speak and therefore cannot communicate needs. Communication is only possible through eye movement, which requires a lot of patience on the part of the caregiver. Understanding the patient’s language is a complex process that requires a lot of empathy.
The swallowing muscles are also paralyzed, which is why an artificial diet must be sought at the beginning. This can be provided either via a stomach tube or infusions. The advantage of feeding through a gastric tube is that the gastrointestinal tract can continue to perform its function and the risk of additional illness is reduced.
