{"id":5446,"date":"2025-12-09T13:10:31","date_gmt":"2025-12-09T18:10:31","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5446"},"modified":"2025-12-09T23:10:27","modified_gmt":"2025-12-10T04:10:27","slug":"locked-in-syndrome-and-unresponsive-wakefulness-syndrome","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/locked-in-syndrome-and-unresponsive-wakefulness-syndrome\/","title":{"raw":"11p6  Locked-in Syndrome and\u00a0Unresponsive Wakefulness Syndrome","rendered":"11p6  Locked-in Syndrome and\u00a0Unresponsive Wakefulness Syndrome"},"content":{"raw":"<strong>Locked-in Syndrome, \u00a0Unresponsive Wakefulness Syndrome, and Brain Imaging<\/strong>\r\n<h1><strong>Overview<\/strong><\/h1>\r\n<ul>\r\n \t<li>These conditions involve severe neurological impairment but differ in awareness and motor function.<\/li>\r\n<\/ul>\r\n<h1><strong>Locked-in Syndrome<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Characteristics<\/strong>:\r\n<ul>\r\n \t<li>GCS score (3-8), low scores can be similar to coma and misleading, as low motor impairment scores hide patient's awareness.<\/li>\r\n \t<li><strong>Patient is awake, aware,<\/strong>\u00a0and fully conscious but\u00a0<strong>completely paralyzed<\/strong>.<\/li>\r\n \t<li>No voluntary movement or speech; communication sometimes possible <strong>through eye movements<\/strong>.<\/li>\r\n \t<li>Often<strong> brainstem functions<\/strong>\u00a0(breathing, heartbeat) remain\u00a0<strong>intact<\/strong>.<\/li>\r\n \t<li><strong>Presence<\/strong> of <strong>brainstem reflexes<\/strong> (e.g., pupil, corneal, gag, doll's eye, oculocephalic) and <strong>cerebral brain activity<\/strong> can help distinguish Locked-In Syndrome from coma.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Cause<\/strong>:\r\n<ul>\r\n \t<li>Damage to\u00a0<strong>brainstem<\/strong>\u00a0(often the pons).<\/li>\r\n \t<li><strong>Cerebral cortex<\/strong>\u00a0preserved.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Case example<\/strong>:\r\n<ul>\r\n \t<li>Jean-Dominique Beauby, a columnist, was paralyzed from stroke affecting the brainstem, resulting in Locked-In syndrome, but communicated via blinking.<\/li>\r\n \t<li>Using\u00a0<strong>eye movements<\/strong>\u00a0and\u00a0<strong>brain-imaging<\/strong>, he communicated complex ideas and even authored a book, \"The Diving Bell and the Buttefly\".<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Assessment via Imaging<\/strong>:\r\n<ul>\r\n \t<li><strong>EEG<\/strong>\u00a0and\u00a0<strong>functional MRI<\/strong>\u00a0can detect\u00a0<strong>brain activity<\/strong>.<\/li>\r\n \t<li>Patients showing\u00a0<strong>awake and responsive<\/strong> states can be distinguished from <strong>coma<\/strong> or <strong>unresponsive wakefulness syndrome<\/strong> states.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Research<\/strong>:\r\n<ul>\r\n \t<li>Imaging\u00a0<strong>brain activity<\/strong> during imagined tasks allows a patient to answer yes\/no questions.<\/li>\r\n \t<li>During fMRI, patent is asked to :\r\n<ul>\r\n \t<li><strong>Imagine walking in a room to \"say yes\"<\/strong>: activates spatial\/motor areas (answer \"yes\").<\/li>\r\n \t<li><strong>Imagine playing tennis to \"say no\"<\/strong>: activates motor areas (answer \"no\").<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Helps facilitate communication with patient<\/li>\r\n \t<li>Helps<strong> detect patient's awareness<\/strong>\u00a0and\u00a0<strong>emotional responses<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>\u00a0Unresponsive Wakefulness Syndrome (UWS)<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Features<\/strong>:\r\n<ul>\r\n \t<li>Appears awake, eyes are open, but <strong>no awareness<\/strong>.<\/li>\r\n \t<li>No responses to\u00a0<strong>verbal or painful stimuli<\/strong>.<\/li>\r\n \t<li><strong>Unresponsive Wakefulness Syndrome<\/strong> describes patients who are <strong>awake<\/strong>\u00a0but\u00a0<strong>consciousness<\/strong>\u00a0is absent.<\/li>\r\n \t<li>Requires\u00a0<strong>long-term care<\/strong>; some patients recover, others do not.<\/li>\r\n \t<li>Formerly known as Vegetative State<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Causes<\/strong>\r\n<ul>\r\n \t<li>Usually results from\u00a0<strong>severe trauma<\/strong>\u00a0or\u00a0<strong>cerebral hypoxia<\/strong>\u00a0(lack of oxygen):\r\n<ul>\r\n \t<li>Brain tissue, especially\u00a0<strong>cerebral hemispheres<\/strong>, is extensively damaged.<\/li>\r\n \t<li>The\u00a0<strong>brainstem<\/strong>\u00a0remains\u00a0<strong>intact<\/strong>:\r\n<ul>\r\n \t<li><strong>Autonomic functions<\/strong>\u00a0such as\u00a0<strong>heart rate<\/strong>,\u00a0<strong>breathing<\/strong>,\u00a0<strong>blood pressure<\/strong>\u00a0are maintained.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>The\u00a0<strong>reticular activating system (RAS)<\/strong>\u00a0remains functional, allowing wakefulness.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<strong>Imaging Techniques and Findings<\/strong>\r\n<ul>\r\n \t<li><strong>MRI<\/strong>:\r\n<ul>\r\n \t<li>Shows lack of activity in\u00a0<strong>cerebral hemispheres<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>EEG<\/strong>:\r\n<ul>\r\n \t<li>Shows\u00a0<strong>absence of cortical activity<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>PET scans<\/strong>:\r\n<ul>\r\n \t<li>Show\u00a0<strong>reduced<\/strong>\u00a0or\u00a0<strong>absent<\/strong>\u00a0activity in\u00a0<strong>higher brain centers<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<ul>\r\n \t<li><strong>Brain - reduced activity<\/strong>:\r\n<ul>\r\n \t<li>Indicates\u00a0<strong>extensive damage<\/strong>\u00a0to\u00a0<strong>thinking and feeling regions<\/strong>.<\/li>\r\n \t<li>Brain\u00a0<strong>no longer perceives or interprets<\/strong>\u00a0sensory information.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<strong>Clinical Features<\/strong>\r\n<ul>\r\n \t<li><strong>Wakefulness<\/strong>:\r\n<ul>\r\n \t<li>Eyes are open, often tracking movements.<\/li>\r\n \t<li>Can follow\u00a0<strong>reflexive movements<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Lack of awareness<\/strong>:\r\n<ul>\r\n \t<li>No response to questions or commands.<\/li>\r\n \t<li>No appropriate responses despite apparent wakefulness.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Reflexes<\/strong>:\r\n<ul>\r\n \t<li>Pupillary, corneal, gag, and oculocephalic reflexes are usually\u00a0<strong>intact<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Behavior<\/strong>:\r\n<ul>\r\n \t<li>Not able to\u00a0<strong>perceive<\/strong>\u00a0or\u00a0<strong>respond meaningfully<\/strong>.<\/li>\r\n \t<li>No\u00a0<strong>cognitive<\/strong>\u00a0or\u00a0<strong>emotional<\/strong>\u00a0processing.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<strong>Functional Status<\/strong>\r\n<ul>\r\n \t<li>Patients can\u00a0<strong>breathe independently<\/strong>\u00a0and\u00a0<strong>maintain blood pressure<\/strong>.<\/li>\r\n \t<li>May be\u00a0<strong>bedridden<\/strong>\u00a0and require\u00a0<strong>caregiving<\/strong>.<\/li>\r\n \t<li>Some may\u00a0<strong>recover<\/strong>; about\u00a0<strong>50%<\/strong>\u00a0show improvement within one month.<\/li>\r\n \t<li>Others remain\u00a0<strong>permanently in UWS<\/strong>.<\/li>\r\n<\/ul>\r\n<strong>Duration and Prognosis<\/strong>\r\n<ul>\r\n \t<li>Can persist\u00a0<strong>months to years<\/strong>.<\/li>\r\n \t<li><strong>Temporary<\/strong>\u00a0(less than 1 month): Often\u00a0<strong>improves<\/strong>.<\/li>\r\n \t<li><strong>Persistent<\/strong>\u00a0or long-term:\r\n<ul>\r\n \t<li>Likely to\u00a0<strong>remain<\/strong>\u00a0for\u00a0<strong>months or years<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Recovery chances<\/strong>\u00a0decrease over time.<\/li>\r\n<\/ul>\r\n<strong>Glasgow Coma Scale and UWS<\/strong>\r\n<ul>\r\n \t<li>Scores can range\u00a0<strong>from 3\u20139<\/strong>:<\/li>\r\n \t<li>Usually <strong style=\"text-align: initial;font-size: 1em\">lower end<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0of the scale, indicating\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\">more severe<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0impairment.<\/span><\/li>\r\n<\/ul>\r\n<h1><strong>Brain Imaging and Function Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>PET scans<\/strong>:\r\n<ul>\r\n \t<li>Show activity levels.<\/li>\r\n \t<li><strong>Normal<\/strong>: High activity in brain at rest.<\/li>\r\n \t<li><strong>Locked-in<\/strong>: Activity\u00a0<strong>preserved<\/strong>\u00a0in cerebral cortex (awake, conscious).<\/li>\r\n \t<li><strong>Unresponsive Wakefulness Syndrome<\/strong>: Activity\u00a0<strong>significantly decreased<\/strong>.<\/li>\r\n \t<li><strong>Minimally conscious<\/strong>: Small, impaired activity.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Summary Table<\/strong><\/h1>\r\n<table class=\"grid landscape\">\r\n<thead>\r\n<tr class=\"shaded\">\r\n<td><strong>Condition<\/strong><\/td>\r\n<td><strong>Brain Activity (PET)<\/strong><\/td>\r\n<td><strong>Awareness<\/strong><\/td>\r\n<td><strong>Motor Function<\/strong><\/td>\r\n<\/tr>\r\n<\/thead>\r\n<tbody>\r\n<tr>\r\n<td><strong>Normal<\/strong><\/td>\r\n<td>High activity<\/td>\r\n<td>Fully aware<\/td>\r\n<td>Fully mobile<\/td>\r\n<\/tr>\r\n<tr>\r\n<td><strong>Locked-in<\/strong><\/td>\r\n<td>Preserved activity<\/td>\r\n<td>Fully aware<\/td>\r\n<td>Paralyzed, communicates via eyes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td><strong>Unresponsive Wakefulness Syndrome<\/strong><\/td>\r\n<td>Low activity<\/td>\r\n<td>No awareness<\/td>\r\n<td>No voluntary movement<\/td>\r\n<\/tr>\r\n<tr>\r\n<td><strong>Minimally conscious<\/strong><\/td>\r\n<td>Limited activity<\/td>\r\n<td>Partial awareness<\/td>\r\n<td>Partial movements<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<strong>Practical Applications<\/strong>\r\n<ul>\r\n \t<li><strong>Imaging<\/strong>\u00a0helps differentiate between\u00a0<strong>coma<\/strong>,\u00a0<strong>locked-in<\/strong>, and <strong>UWS<\/strong> states.<\/li>\r\n \t<li><strong>Communication<\/strong>\u00a0possible via\u00a0<strong>brain-controlled interfaces<\/strong>\u00a0in locked-in syndrome.<\/li>\r\n \t<li><strong>Understanding<\/strong>\u00a0brain function guides treatment and prognosis.<\/li>\r\n<\/ul>","rendered":"<p><strong>Locked-in Syndrome, \u00a0Unresponsive Wakefulness Syndrome, and Brain Imaging<\/strong><\/p>\n<h1><strong>Overview<\/strong><\/h1>\n<ul>\n<li>These conditions involve severe neurological impairment but differ in awareness and motor function.<\/li>\n<\/ul>\n<h1><strong>Locked-in Syndrome<\/strong><\/h1>\n<ul>\n<li><strong>Characteristics<\/strong>:\n<ul>\n<li>GCS score (3-8), low scores can be similar to coma and misleading, as low motor impairment scores hide patient&#8217;s awareness.<\/li>\n<li><strong>Patient is awake, aware,<\/strong>\u00a0and fully conscious but\u00a0<strong>completely paralyzed<\/strong>.<\/li>\n<li>No voluntary movement or speech; communication sometimes possible <strong>through eye movements<\/strong>.<\/li>\n<li>Often<strong> brainstem functions<\/strong>\u00a0(breathing, heartbeat) remain\u00a0<strong>intact<\/strong>.<\/li>\n<li><strong>Presence<\/strong> of <strong>brainstem reflexes<\/strong> (e.g., pupil, corneal, gag, doll&#8217;s eye, oculocephalic) and <strong>cerebral brain activity<\/strong> can help distinguish Locked-In Syndrome from coma.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Cause<\/strong>:\n<ul>\n<li>Damage to\u00a0<strong>brainstem<\/strong>\u00a0(often the pons).<\/li>\n<li><strong>Cerebral cortex<\/strong>\u00a0preserved.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Case example<\/strong>:\n<ul>\n<li>Jean-Dominique Beauby, a columnist, was paralyzed from stroke affecting the brainstem, resulting in Locked-In syndrome, but communicated via blinking.<\/li>\n<li>Using\u00a0<strong>eye movements<\/strong>\u00a0and\u00a0<strong>brain-imaging<\/strong>, he communicated complex ideas and even authored a book, &#8220;The Diving Bell and the Buttefly&#8221;.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Assessment via Imaging<\/strong>:\n<ul>\n<li><strong>EEG<\/strong>\u00a0and\u00a0<strong>functional MRI<\/strong>\u00a0can detect\u00a0<strong>brain activity<\/strong>.<\/li>\n<li>Patients showing\u00a0<strong>awake and responsive<\/strong> states can be distinguished from <strong>coma<\/strong> or <strong>unresponsive wakefulness syndrome<\/strong> states.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Research<\/strong>:\n<ul>\n<li>Imaging\u00a0<strong>brain activity<\/strong> during imagined tasks allows a patient to answer yes\/no questions.<\/li>\n<li>During fMRI, patent is asked to :\n<ul>\n<li><strong>Imagine walking in a room to &#8220;say yes&#8221;<\/strong>: activates spatial\/motor areas (answer &#8220;yes&#8221;).<\/li>\n<li><strong>Imagine playing tennis to &#8220;say no&#8221;<\/strong>: activates motor areas (answer &#8220;no&#8221;).<\/li>\n<\/ul>\n<\/li>\n<li>Helps facilitate communication with patient<\/li>\n<li>Helps<strong> detect patient&#8217;s awareness<\/strong>\u00a0and\u00a0<strong>emotional responses<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>\u00a0Unresponsive Wakefulness Syndrome (UWS)<\/strong><\/h1>\n<ul>\n<li><strong>Features<\/strong>:\n<ul>\n<li>Appears awake, eyes are open, but <strong>no awareness<\/strong>.<\/li>\n<li>No responses to\u00a0<strong>verbal or painful stimuli<\/strong>.<\/li>\n<li><strong>Unresponsive Wakefulness Syndrome<\/strong> describes patients who are <strong>awake<\/strong>\u00a0but\u00a0<strong>consciousness<\/strong>\u00a0is absent.<\/li>\n<li>Requires\u00a0<strong>long-term care<\/strong>; some patients recover, others do not.<\/li>\n<li>Formerly known as Vegetative State<\/li>\n<\/ul>\n<\/li>\n<li><strong>Causes<\/strong>\n<ul>\n<li>Usually results from\u00a0<strong>severe trauma<\/strong>\u00a0or\u00a0<strong>cerebral hypoxia<\/strong>\u00a0(lack of oxygen):\n<ul>\n<li>Brain tissue, especially\u00a0<strong>cerebral hemispheres<\/strong>, is extensively damaged.<\/li>\n<li>The\u00a0<strong>brainstem<\/strong>\u00a0remains\u00a0<strong>intact<\/strong>:\n<ul>\n<li><strong>Autonomic functions<\/strong>\u00a0such as\u00a0<strong>heart rate<\/strong>,\u00a0<strong>breathing<\/strong>,\u00a0<strong>blood pressure<\/strong>\u00a0are maintained.<\/li>\n<\/ul>\n<\/li>\n<li>The\u00a0<strong>reticular activating system (RAS)<\/strong>\u00a0remains functional, allowing wakefulness.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Imaging Techniques and Findings<\/strong><\/p>\n<ul>\n<li><strong>MRI<\/strong>:\n<ul>\n<li>Shows lack of activity in\u00a0<strong>cerebral hemispheres<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>EEG<\/strong>:\n<ul>\n<li>Shows\u00a0<strong>absence of cortical activity<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>PET scans<\/strong>:\n<ul>\n<li>Show\u00a0<strong>reduced<\/strong>\u00a0or\u00a0<strong>absent<\/strong>\u00a0activity in\u00a0<strong>higher brain centers<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Brain &#8211; reduced activity<\/strong>:\n<ul>\n<li>Indicates\u00a0<strong>extensive damage<\/strong>\u00a0to\u00a0<strong>thinking and feeling regions<\/strong>.<\/li>\n<li>Brain\u00a0<strong>no longer perceives or interprets<\/strong>\u00a0sensory information.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Clinical Features<\/strong><\/p>\n<ul>\n<li><strong>Wakefulness<\/strong>:\n<ul>\n<li>Eyes are open, often tracking movements.<\/li>\n<li>Can follow\u00a0<strong>reflexive movements<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Lack of awareness<\/strong>:\n<ul>\n<li>No response to questions or commands.<\/li>\n<li>No appropriate responses despite apparent wakefulness.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Reflexes<\/strong>:\n<ul>\n<li>Pupillary, corneal, gag, and oculocephalic reflexes are usually\u00a0<strong>intact<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Behavior<\/strong>:\n<ul>\n<li>Not able to\u00a0<strong>perceive<\/strong>\u00a0or\u00a0<strong>respond meaningfully<\/strong>.<\/li>\n<li>No\u00a0<strong>cognitive<\/strong>\u00a0or\u00a0<strong>emotional<\/strong>\u00a0processing.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Functional Status<\/strong><\/p>\n<ul>\n<li>Patients can\u00a0<strong>breathe independently<\/strong>\u00a0and\u00a0<strong>maintain blood pressure<\/strong>.<\/li>\n<li>May be\u00a0<strong>bedridden<\/strong>\u00a0and require\u00a0<strong>caregiving<\/strong>.<\/li>\n<li>Some may\u00a0<strong>recover<\/strong>; about\u00a0<strong>50%<\/strong>\u00a0show improvement within one month.<\/li>\n<li>Others remain\u00a0<strong>permanently in UWS<\/strong>.<\/li>\n<\/ul>\n<p><strong>Duration and Prognosis<\/strong><\/p>\n<ul>\n<li>Can persist\u00a0<strong>months to years<\/strong>.<\/li>\n<li><strong>Temporary<\/strong>\u00a0(less than 1 month): Often\u00a0<strong>improves<\/strong>.<\/li>\n<li><strong>Persistent<\/strong>\u00a0or long-term:\n<ul>\n<li>Likely to\u00a0<strong>remain<\/strong>\u00a0for\u00a0<strong>months or years<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Recovery chances<\/strong>\u00a0decrease over time.<\/li>\n<\/ul>\n<p><strong>Glasgow Coma Scale and UWS<\/strong><\/p>\n<ul>\n<li>Scores can range\u00a0<strong>from 3\u20139<\/strong>:<\/li>\n<li>Usually <strong style=\"text-align: initial;font-size: 1em\">lower end<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0of the scale, indicating\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\">more severe<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0impairment.<\/span><\/li>\n<\/ul>\n<h1><strong>Brain Imaging and Function Summary<\/strong><\/h1>\n<ul>\n<li><strong>PET scans<\/strong>:\n<ul>\n<li>Show activity levels.<\/li>\n<li><strong>Normal<\/strong>: High activity in brain at rest.<\/li>\n<li><strong>Locked-in<\/strong>: Activity\u00a0<strong>preserved<\/strong>\u00a0in cerebral cortex (awake, conscious).<\/li>\n<li><strong>Unresponsive Wakefulness Syndrome<\/strong>: Activity\u00a0<strong>significantly decreased<\/strong>.<\/li>\n<li><strong>Minimally conscious<\/strong>: Small, impaired activity.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Summary Table<\/strong><\/h1>\n<table class=\"grid landscape\">\n<thead>\n<tr class=\"shaded\">\n<td><strong>Condition<\/strong><\/td>\n<td><strong>Brain Activity (PET)<\/strong><\/td>\n<td><strong>Awareness<\/strong><\/td>\n<td><strong>Motor Function<\/strong><\/td>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Normal<\/strong><\/td>\n<td>High activity<\/td>\n<td>Fully aware<\/td>\n<td>Fully mobile<\/td>\n<\/tr>\n<tr>\n<td><strong>Locked-in<\/strong><\/td>\n<td>Preserved activity<\/td>\n<td>Fully aware<\/td>\n<td>Paralyzed, communicates via eyes<\/td>\n<\/tr>\n<tr>\n<td><strong>Unresponsive Wakefulness Syndrome<\/strong><\/td>\n<td>Low activity<\/td>\n<td>No awareness<\/td>\n<td>No voluntary movement<\/td>\n<\/tr>\n<tr>\n<td><strong>Minimally conscious<\/strong><\/td>\n<td>Limited activity<\/td>\n<td>Partial awareness<\/td>\n<td>Partial movements<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Practical Applications<\/strong><\/p>\n<ul>\n<li><strong>Imaging<\/strong>\u00a0helps differentiate between\u00a0<strong>coma<\/strong>,\u00a0<strong>locked-in<\/strong>, and <strong>UWS<\/strong> states.<\/li>\n<li><strong>Communication<\/strong>\u00a0possible via\u00a0<strong>brain-controlled interfaces<\/strong>\u00a0in locked-in syndrome.<\/li>\n<li><strong>Understanding<\/strong>\u00a0brain function guides treatment and prognosis.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":13,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5446","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":76,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5446","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":10,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5446\/revisions"}],"predecessor-version":[{"id":5547,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5446\/revisions\/5547"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/76"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5446\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5446"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5446"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5446"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5446"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}