Pseudo Coma; A Case of Locked In Syndrome

We will be discussing a medical condition of South African who was in coma for 12 years. This is the medical case of Martin Pistorius who came back from school with sore throat and that was the beginning of a long time medical journey in his life.

He was a brilliant child who would build electrical appliances and would repair the ones in their homes that weren't working properly. With this, his mum loved him and was willing to help him grow his career as an electrical electronics engineer in the future but then, one day in January of 1988 he came home from school with a sore throat which looked like a simple thing but gradually, he was unable to eat, and was then finding it difficult to walk as he was experiencing serious pain which kept growing.

Soon he was unable to move his body, and this caused its body to become weaker and so did his mind start to grow weak. Soon he went into a waking coma where he could see things but could not move his body. Later, he went to losing faces, and other cognitive abilities. Several test was done on him to find a diagnosis but this didn't work as they were unable to find anything wrong with him. He was unable to drink and eat and was being treated for tuberculosis and Cryptococcal meningitis but then they didn't get the underlying cause of this illnesses.

The doctors were only keeping him with the basics and just waited for him to die or waited till they found something. Soon he was able to recognize himself as he came back to himself but he was unable to move himself and couldn't tell anywhere he was out of waking coma as he could not talk or move. Since he could not communicate, he decided to be lost in his imagination.

At this point, he had suffered from Locked In Syndrome (LIS) which is like the mind being locked inside the body. For the case of Martin Pistorius, he was suffering from classical LIS as he had total bodily paralysis, but could still move is eyes vertically but not horizontally. His cognitive functions and hearing were intact as the person can see, hear, and understand but cannot move or say anything. With incomplete LIS, the person can still move a little as they are not completely paralyzed. With total immobility LIS, there is no way the person can move their body, and they cannot move their eyes.

Locked In Syndrome (LIS) is trigger by the damage of the Pons of the Brain stem which is a pathway between the cerebrum, cerebellum, and the spinal cord. People with locked in syndrome cannot speak, move, chew, make facial expression but can hear, reason, understand, and maintain sleep-wake cycle. The hemorrhage of the brainstem can lead to bleeding in or around it which could be caused by high blood pressure, brain trauma, extreme drug abuse, tumor, infection, heart disease, and infarct which is the necrotizing of brain tissues as a result of lack of blood.

It can be regarded as a pseudocoma, and people can have difficulty doing anything, and there is no treatment for it. People who have locked in syndrome are usually paralyzed but then do not mistake Stephen Hawking to suffer from locked-in syndrome because he didn't suffer from it, rather he suffered from Amyotrophic Lateral Sclerosis which cause his entire body to be paralyzed. It is a degenerative motor disease which means I cannot perform motor functions including speaking but his words were communicated to word and he left his name in the sands of time.

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Reference

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https://www.ted.com/talks
https://www.theguardian.com
https://my.clevelandclinic.org/health
https://www.ncbi.nlm.nih.gov/books/NBK525986/
https://www.cdc.gov/fungal
https://www.who.int/news-room/fact-sheets/detail/tuberculosis

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Image Reference

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Image 1 ||Wikimedia || Brisa Alfaro
Image 2 || Flickr || Martin Pistorius