Editing Locked-in syndrome (section)

==Diagnosis==
Locked-in syndrome can be difficult to diagnose. In a 2002 survey of 44 people with LIS, it took almost three months to recognize and diagnose the condition after it had begun.<ref>{{cite journal|last1=León-Carrión|first1=J.|last2=van Eeckhout|first2=P.|last3=Domínguez-Morales Mdel|first3=R.|last4=Pérez-Santamaría|first4=F. J.|title=The locked-in syndrome: a syndrome looking for a therapy|journal=Brain Inj.|date=2002|volume=16|issue=7|pages=571–82|doi=10.1080/02699050110119781|pmid=12119076|s2cid=20970974}}</ref> However, it has reported that it can take upwards of four years to receive a diagnosis<ref>{{Citation |last1=Laureys |first1=Steven |title=The locked-in syndrome : what is it like to be conscious but paralyzed and voiceless? |date=2005 |work=Progress in Brain Research |volume=150 |pages=495–611 |url=https://linkinghub.elsevier.com/retrieve/pii/S0079612305500347 |access-date=2025-05-12 |publisher=Elsevier |language=en |doi=10.1016/s0079-6123(05)50034-7 |isbn=978-0-444-51851-4 |last2=Pellas |first2=Frédéric |last3=Van Eeckhout |first3=Philippe |last4=Ghorbel |first4=Sofiane |last5=Schnakers |first5=Caroline |last6=Perrin |first6=Fabien |last7=Berré |first7=Jacques |last8=Faymonville |first8=Marie-Elisabeth |last9=Pantke |first9=Karl-Heinz}}</ref>.  Locked-in syndrome may mimic [[Unconsciousness|loss of consciousness]] in patients, or, in the case that respiratory control is lost, may even resemble death. People are also unable to actuate standard motor responses such as [[Withdrawal reflex|withdrawal from pain]]; as a result, testing often requires making requests of the patient such as blinking or vertical eye movement.{{citation needed|date=December 2020}}

Brain imaging may provide additional indicators of locked-in syndrome, as brain imaging provides clues as to whether or not brain function has been lost. Additionally, an [[Electroencephalography|EEG]] can allow the observation of sleep-wake patterns indicating that the patient is not unconscious but simply unable to move.<ref name="Merck Manual">{{cite web|last=Maiese|first=Kenneth|url=https://www.merckmanuals.com/professional/neurologic-disorders/coma-and-impaired-consciousness/locked-in-syndrome|title = Locked-in Syndrome|date=March 2014}}</ref> If no mass or vascular lesion is present on the imaging scan, cerebrospinal fluid examination may be used to reveal an infectious or autoimmune root of the symptoms.<ref>{{Citation |last1=Das |first1=Joe M. |title=Locked-in Syndrome |date=2025 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK559026/ |access-date=2025-05-12 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32644452 |last2=Anosike |first2=Kingsley |last3=Asuncion |first3=Ria Monica D.}}</ref> Similarly, blood tests can detect fluctuations in sodium concentration, that would be indicative of hyponatremia, as well as glucose levels should be monitored to eliminate the possibility of a hypoglycemic coma.

=== Similar conditions ===
* [[Akinetic mutism]]
* [[Unresponsive wakefulness syndrome]]
* [[Minimally conscious state]]
* [[Amyotrophic lateral sclerosis]] (ALS)
* [[Brain tumor|Bilateral brainstem tumor]]s
* [[Brain death]] (of the whole brain or the brainstem or other part)
* [[Coma]] (deep or irreversible)
* [[Guillain–Barré syndrome]]
* [[Myasthenia gravis]]
* [[Poliomyelitis]]
* [[Peripheral neuropathy|Polyneuritis]]
* [[Vegetative state]] (chronic or otherwise)