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Transient total locked-in syndrome due to vertebral and basilar artery dissection
  1. Yuichiro Inatomi1,
  2. Makoto Nakajima2 and
  3. Toshiro Yonahara1
  1. 1Department of Neurology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
  2. 2Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
  1. Correspondence to Dr Yuichiro Inatomi; y.inatomix{at}


A 52-year-old woman suddenly presented with right conjugate eye deviation, anarthria and quadriplegia, and appeared to be in a deep coma. MRI revealed a new infarct in the left cerebellar hemisphere and stenosis in the distal portion of the basilar artery caused by arterial dissection. Her deficits improved within 6 hours of onset. Moreover, on day 1, she described that she had been alert and her vision, hearing and somatic sensation had been preserved during the illness. Total locked-in syndrome should be considered while assessing patients with total immobility who are unable to communicate.

  • stroke
  • brain stem / cerebellum

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  • Contributors Patient was under the care of YI. Report was written by YI, MN and TY.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.