2025 ICD-10-CM code G83.5
(Valid) Effective Date: N/A Diseases of the nervous system - Other paralytic syndromes 6 Feed
Locked-in syndrome.A rare neurological disorder characterized by complete paralysis of voluntary muscles, except for those controlling eye movement.
Medical necessity for services related to locked-in syndrome stems from the need for life-sustaining treatment (e.g., respiratory support, nutritional support) and management of complications. Physical therapy and assistive devices are necessary for maximizing functional abilities and improving quality of life.
Physicians diagnose locked-in syndrome based on medical history, signs, symptoms, and physical examination.They may order various tests (MRI, EEG, EMG, NCV) to pinpoint the cause and assess the severity. Management focuses on supportive care, including respiratory support, nutritional support, and preventing complications.Physical therapy and assistive devices are also important aspects of care.
In simple words: Locked-in syndrome is a rare condition where a person is completely paralyzed except for their eye muscles. They can think and understand, but cannot move or speak. They can communicate by blinking or moving their eyes.This is caused by damage to a part of the brainstem. Treatment focuses on keeping the person healthy and comfortable and helping them communicate.
Locked-in syndrome results from damage to the pons (part of the brainstem) due to infarction or hemorrhage, disrupting communication between the brain and voluntary muscles.This leads to paralysis of muscles responsible for chewing, swallowing, breathing, speaking, and limb movement, sparing eye movement. Cognitive function is typically preserved, allowing communication through eye blinks or vertical/lateral eye movements. Diagnosis involves medical history, physical examination, and studies such as MRI, EEG, EMG, and nerve conduction velocity tests.Treatment focuses on supportive care including ventilator support, enteral nutrition, physiotherapy, assistive devices, and preventing complications like respiratory infections and pressure ulcers.
Example 1: A patient presents with sudden onset quadriplegia and an inability to speak or swallow, but retains consciousness and vertical eye movements. An MRI reveals an infarct in the pons.The patient is diagnosed with locked-in syndrome., Following a brainstem hemorrhage, a patient exhibits complete paralysis of voluntary muscles except for eye movements.They communicate by blinking in response to questions.This clinical picture aligns with locked-in syndrome., A patient in the intensive care unit after a traumatic brain injury develops locked-in syndrome.The medical team focuses on supportive care, including ventilator support, enteral nutrition, and prevention of complications like pneumonia and pressure sores.
Documentation should include details of the neurological examination, including assessment of eye movements and cognitive function.Results of imaging studies (MRI), electrophysiological studies (EEG, EMG, NCV), and details of supportive care provided should be documented.
- Specialties:Neurology, Critical Care Medicine, Physical Medicine and Rehabilitation
- Place of Service:Inpatient Hospital, Skilled Nursing Facility, Long-term Care Hospital