"Locked-In" State With Bilateral Midbrain Infarcts

Abstract

A fully conscious patient was quadriplegic and anarthric (locked-in); ocular movements were preserved. At autopsy, the lateral two thirds of both cerebral peduncles were infarcted secondary to thrombosis of the rostral basilar artery. The ventral pons was essentially intact. It is concluded that the locked-in state is not synonymous with the ventral pontine syndrome, as previously stated. Other anatomical locations must be considered when this syndrome is diagnosed clinically.