Question

Why do some people with Locked in Syndrome have eye movements vertically but not horizontally?

Answer 1

Answer:

Locked‐in syndrome (de‐efferented state) is the result of bilateral ventral pontine lesions that produce quadriplegia, aphonia, and impairment of the horizontal eye movements in some patients. Wakefulness is maintained due to sparing of the reticular formation. Patients can move their eyes vertically and can blink because the supranuclear ocular motor pathways lie more dorsally (see Chapter 1). In some patients, there is a “herald” hemiparesis that makes the lesion appear to be cortical in nature. However, within a few hours, there is progression to bilateral hemiplegia and CN findings associated with the locked‐in syndrome.

Explanation: