Article

Locked-in syndrome (LIS) is a rare neurologic condition caused by bilateral
pontine lesions. Quadriplegia is one of the most serious clinical manifestations
in patients with LIS. However, little is known about the motor recovery mechanism
of quadriplegia in patients with LIS. In the current study, we present with a
quadriplegic patient with bilateral pontine infarcts, whose motor function
appeared to be reorganized into the peri-infarct areas of the infarcted pons, as
demonstrated by diffusion tensor tractography (DTT).
A 60-year-old was diagnosed
as LIS due to bilateral pontine infarcts 6 years ago. The patient presented with
complete paralysis of all four extremities at onset. After slow motor recovery,
the patient was able to move all joint muscles against gravity and demonstrated
some fine motor activity at the time of DTT scanning (6 years after onset).
Results of DTTs for the corticospinal tract (CST) in both hemispheres showed that
the CSTs originated from the primary motor cortex, descended along the known CST
pathway, and passed through lateral areas of infarcts in the pons. Therefore,
motor function of the four extremities of this patient appears to have been
recovered by the CST, which passed through the lateral areas to the pontine
infarcts.

Langue : ANGLAIS