Locked-in syndrome (LIS) What is the cause?

[Soren]

Just read an interesting story about locked-in syndrome and wondered what the cause might be? My assumption is some kind of bacterial infection but am curious if Peat has ever spoken on the subject, I can't find anything.

There are some heart wrenching and fascinating stories where people have been assumed to be in a vegetative state for many years but were completely aware of their surroundings. I'm not reffering to the cases where there has been some obvious traumatic brain injury or stroke but ones that seem to have occurred without any physical trauma.

This is the cause offered by rarediseases.org
"Locked-in syndrome may be caused by brain stem stroke, traumatic brain injury, tumors, diseases of the circulatory system (bleeding), diseases that destroy the myelin sheath surrounding nerve cells (like multiple sclerosis), infection, or medication overdose."
Rarediseases.org

 

[AspiringSage]

Virus, toxins and extreme vitamin deficiency also seem like candidates for inducing paralysis.

 

[Peater]

Pesticides like with polio

 

[Soren]

Virus, toxins and extreme vitamin deficiency also seem like candidates for inducing paralysis.

Any thoughts as to what vitamins specifically would lead to paralysis? I know low vitamin A causes blindness.

Just found a case study that shows folic acid deficiency can lead to locked in syndrome.

Hyperhomocysteinemia induced locked-in syndrome in a young adult due to folic acid deficiency

"A 16-year-old boy presented with complaints of sudden onset weakness of all the four limbs with loss of voice for one day. All the tendon reflexes were increased, bilateral planters were extensor and sensory system was intact. Patient was conscious and responded to verbal commands by ocular movements in vertical direction. Hence, a diagnosis of LIS was made. Magnetic resonance imaging of the head revealed an acute infarct in ventral pons. Serum homocysteine level was elevated (20.65 μmol/l) and folic acid level was severely low (1.7 nmol/ml). Cause of LIS was found to be hyperhomocysteinemia induced stroke in the pons, related to folic acid deficiency. The patient was managed with antiplatelet agents and folic acid supplementation and was discharged subsequently."

 

[Peatful]

I know nothing...
But for discussion sake I will throw out:
a combination of a severe limbic system dysfunction along with some cerebellum involvement.

 

[AspiringSage]

Any thoughts as to what vitamins specifically would lead to paralysis? I know low vitamin A causes blindness.

Just found a case study that shows folic acid deficiency can lead to locked in syndrome.

Hyperhomocysteinemia induced locked-in syndrome in a young adult due to folic acid deficiency

"A 16-year-old boy presented with complaints of sudden onset weakness of all the four limbs with loss of voice for one day. All the tendon reflexes were increased, bilateral planters were extensor and sensory system was intact. Patient was conscious and responded to verbal commands by ocular movements in vertical direction. Hence, a diagnosis of LIS was made. Magnetic resonance imaging of the head revealed an acute infarct in ventral pons. Serum homocysteine level was elevated (20.65 μmol/l) and folic acid level was severely low (1.7 nmol/ml). Cause of LIS was found to be hyperhomocysteinemia induced stroke in the pons, related to folic acid deficiency. The patient was managed with antiplatelet agents and folic acid supplementation and was discharged subsequently."

B1, B6, B9 (as you linked above) and B12 all come to mind. I would expect mild issues to manifest well short of paralysis in most people. Some indication that there was a problem even it it was ignored. Sometimes too much of a good thing can cause neurological issues as well, see B6 toxicity.

Beriberi, Wernicke encephalopathy, Korsakoff syndrome are all B1 (thiamine) related. People who use nitrous oxide recreationally often develop neurological issues ranging from (tingling to myeloneuropathy) associated with B12 deficiency.

The above shouldn’t be taken as medical advise outside of my lab ferrets gaming account in Minecraft.

 

[Giraffe]

Just read an interesting story about locked-in syndrome and wondered what the cause might be? My assumption is some kind of bacterial infection but am curious if Peat has ever spoken on the subject, I can't find anything.

There are some heart wrenching and fascinating stories where people have been assumed to be in a vegetative state for many years but were completely aware of their surroundings. I'm not reffering to the cases where there has been some obvious traumatic brain injury or stroke but ones that seem to have occurred without any physical trauma.

This is the cause offered by rarediseases.org
"Locked-in syndrome may be caused by brain stem stroke, traumatic brain injury, tumors, diseases of the circulatory system (bleeding), diseases that destroy the myelin sheath surrounding nerve cells (like multiple sclerosis), infection, or medication overdose."
Rarediseases.org

I remember the story of a man who said that something exploded in his head an then he fell to the ground. He was found later and rushed to hospital. In the ambulance he heard how he was declared dead.

He was not dead and he recovered enough to be able to tell his story. It was a stroke that caused it for him.

 

[Blossom]

Anoxic brain injury. If a person is found down for whatever reason and and their oxygen levels have been too low for too long and they are resuscitated and survive they can live in a locked in state.

 

[Peater]

People who use nitrous oxide recreationally often develop neurological issues ranging from (tingling to myeloneuropathy) associated with B12 deficiency.

Interesting. I see those little metal canisters discarded everywhere and assumed it was a safe enough high as it's "only" a gas.

 

[AspiringSage]

Interesting. I see those little metal canisters discarded everywhere and assumed it was a safe enough high as it's "only" a gas.

It’s nasty for sure. Like most things with nitrous oxide the dose and duration make the poison. I suspect a lot of Parkinson’s like symptoms in urban homeless populations are associated with nitrous oxide abuse. Sadly, a lot of people presenting to ED’s with tingles or strange pains (where no injury is apparent) are treated with antipsychotics or toradol/ketorolac (IM/IV NSAID) and kicked out the door as drug seeking.

 

[Peater]

It’s nasty for sure. Like most things with nitrous oxide the dose and duration make the poison. I suspect a lot of Parkinson’s like symptoms in urban homeless populations are associated with nitrous oxide abuse. Sadly, a lot of people presenting to ED’s with tingles or strange pains (where no injury is apparent) are treated with antipsychotics or toradol/ketorolac (IM/IV NSAID) and kicked out the door as drug seeking.

I think you're right.

 

[InChristAlone]

Methanol poisoning? It converts to formaldehyde and can destroy brain tissue.

 

[AspiringSage]

Methanol poisoning? It converts to formaldehyde and can destroy brain tissue.

Yep, I’ve seen people drink methylated spirits.

 

[Soren]

Anoxic brain injury. If a person is found down for whatever reason and and their oxygen levels have been too low for too long and they are resuscitated and survive they can live in a locked in state.

Interesting, any thoughts as to what would be the best treatment for a brain deprived of oxygen? I would assume things such as progesterone, methylene blue, red light and other metabolic boosting, nuero-protective substances.

I know there have been studies on red light therapy to treat traumatic brain injury and stroke.

 

[InChristAlone]

Anoxic brain injury. If a person is found down for whatever reason and and their oxygen levels have been too low for too long and they are resuscitated and survive they can live in a locked in state.

That's scary for all the people who were operated on alive to harvest their organs after being declared 'brain dead'.

 

[Blossom]

Interesting, any thoughts as to what would be the best treatment for a brain deprived of oxygen? I would assume things such as progesterone, methylene blue, red light and other metabolic boosting, nuero-protective substances.

I know there have been studies on red light therapy to treat traumatic brain injury and stroke.

The wife of a patient I had did a lot of digging and wanted to try hyperbaric oxygen treatment for her husband but they were denied by insurance. It’s a shame because as far as I know (and I haven’t kept up) it is considered irreversible so no one wants to pursue further research.
Your ideas sound good.

 

[Blossom]

That's scary for all the people who were operated on alive to harvest their organs after being declared 'brain dead'.

Yes, very much so. I’m personally no longer an organ donor.