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A case study of Locked-In-Syndrome: Psychological and personal perspectives

Objectives: Although patients with Locked-In-Syndrome (LIS) are often stated to have normal cognitive functioning, the few reports of neuropsychological assessment in these cases suggest this is not always true. This paper (a) reviews published reports of neuropsychological assessments of LIS patients, (b) presents a detailed neuropsychological assessment of a patient to determine if she has normal cognitive functioning and (c) presents the views of the patient on what has happened to her. Methods and procedures: An in-depth single case report assessing the cognitive and emotional functioning of a young woman with LIS plus a personal account from the patient. Detailed assessments were carried out using standardized neuropsychological tests and questionnaires measuring emotional functioning, pain and quality-of-life. The patient also states her views of what happened and how she feels. Results: On most tests, cognitive functioning was average or above, but some impairments were found (consistent with published literature). No emotional problems were detected. Quality of life was satisfactory. Pain perception was normal. Conclusions: Although LIS patients have no severe cognitive deficits, some cognitive difficulties are common. Despite severe physical and communication problems and some mild cognitive deficits on visual reasoning tasks, this patient feels she has a reasonable quality-of-life.