Psychological contribution to Locked-in syndrome

Locked-in Syndrome is a rare neurological disorder that involve being completely paralyzed at all muscle parts involuntary, except the muscles used to eye movement. Patient experience being completely conscious and able to have cognitive processes like reasoning, but are not able to speak or move at all. The causes of this condition are by a destruction the myelin sheath surrounding nerve cells, that can happen due to medication overdose, brain injury, tumor or diseases of circulatory system.

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The forms of this disease can take three different forms. The classical form is when the person have complete immobility and remain a middle level of consciousness as well as vertical eye movement, while incomplete form have an addition to some motor function to eye movement and consciousness. The last form involve total immobilizes, which involve complete body paralysis including losing the eye movement.
Treatment for locked-in syndrome involve cure for now, but physical therapy as well as using similar treatment for demyelinating disease to support the loss myelin sheath. Nonetheless, the prognosis can be from full recovery to no recovery at all.

Although studies around this disorder is mostly focus from a neurological point of view, like checking their consciousness by blink-response or rapid eye movement-response (Das,2021), there has been some psychological studies around locked-in syndrome to get more insight of the psychological impact the disorder have on a person. In 2007, case report illustrated and discussed from analyzing 36 of poems that a patient wrote about his experience locked-in syndrome. As discussed of the information of the patient`s experience, he describe his conscious experience as trying to hold on to his happiness and hope while being imprisoned in his own body, including that the communication with the staff via eye movement or writing was essential to maintaining it . Hence, the case report concluded to further opportunities to use communication with patient with locked-in syndrome in order to elaborate the cognitive adaption to their condition.

Despite that most of the research around locked-in syndrome goes to discover more direction towards a better treatment, it can be discussed further to research around this disorder should from a psychological perspective as well should be promoted. By further reflecting upon this, collaborating research from these both side can help us not only progress closer to a more effective treatment, but also improve how to take care of the patient psychological being during and after recovery.

-M Das J, Anosike K, Asuncion RMD. Locked-in Syndrome. 2021 Jul 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 32644452.
-Sledz, M., Oddy, M., & Beaumont, J. G. (2007). Psychological adjustment to locked-in syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 78(12), 1407–1408.

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