Episode 66. Entombed - When the Brain is Locked-in

The theme of this podcast episode is the disabling condition of locked-in state. I discuss the typical causes that lead to locked-in state, particularly large strokes in the brainstem, and highlighting cervical dissection is an important mechanism for this. I also review its main clinical manifestations, noting how blinking and eye movements are often the only preserved motor functions, along with the emotional burden it imposes on patients and their families.

I particularly highlight the uncertainty that dominates the early stages when the patient is aware, but family and healthcare personnel assume they are brain dead. Similarly harrowing are the discussions that flavour the management about continuing supportive treatment, and the fearful thoughts that dominate the victims’ experience, from the fear of dying from the condition, or being  ...