Alana Foshay

OTA/PTA

Case assignment

32 year Old Male Locked in Syndrome

PNEU 3302

Laura Maybury

October 8th, 2022

 Pathophysiology

Locked in syndrome (LIS) The classical form- is a rare neurological disorder affecting the
brainstem pons, primarily provoked by having a stroke which occurred in Shawns case.
(“Locked in Syndrome,”2022). This disease usually occurs around the ages of 30-50 years of
age and Shawn is 32. Shawn is married with 2 children in a 1 story apartment. Shawn is in the
early stages of being diagnosed with this disorder. People with this disorder experience full
paralysis but have consciousness and working cognitive abilities as well as the ability for eye
movements and hearing which Shawn is experiencing.
(“Locked in Syndrome,”2022 ). Shawn currently has a Gastronomy tube that has been recently
inserted into his stomach so that he can receive food and water. He also has a Tracheotomy
which is a tube that goes into his airway through a small hole in his throat which helps with his
persistent breathing difficulties.(“Locked in Syndrome,”2022). Currently Shawn is being treated
in the hospital and is working towards being discharged.

WHO/ICF
 Communication strategies, Safety Considerations

Shawn is only able to communicate via blinking, he is also able to hear and comprehend
anything that is spoken or shown to him. He is unable to speak verbally and has no movement
at all except being able to move his head up and down, side to side.
I have started introducing an eye coded system to Shawn on how we will communicate with
myself, the rest of the health team here and his family. (“Locked in Syndrome,” 2022). We have
started simple with a head up for yes and head down for no and we would use only simplistic
yes or no questions. Myself and his family want to work towards using a system called the P300
which is a brain computer interface which would allow Shawn to write words and sentences with
only his brainwaves. Guger et al. (2014) Which would allow him to have a greater level of
conversations besides just being able to say yes or no to increase his quality of life.

30 Minute Treatment Session

Our next treatment session for Shawn I would like him to practice using his new powered
wheelchair which he has only had for a week so he is still learning on how to move it using his
brain waves especially needs work on turning. As well, I would like him to start using the P300
brain computer interface to explain to his family and himself how it works, and have him practice
using it. I would spend 15 minutes on wheelchair work and the rest of the session time on
learning about and becoming familiar with the P300.

Durham Region Community Resource

Speech Therapy Centres of Canada- Speech-language pathologists and their assistants work
with adults and children that have communication disorders. They work towards giving their
patients the greatest quality of life possible. Speech Therapy Centres. (n.d.)

Motion Specialties- Where you may pick up, get your equipment fixed as well as ask questions
about any of your wheelchair needs. Motion Cares. (n.d.)

ACSS program services(Adult Community Support Services)- Program provides support to

adults and helps them to live as independently as possible.
Adults with Developmental Disabilities Services. (n.d.)
 Bullet Round Summary Handout

● Patient is Shawn, he is 32, he has experienced a stroke and has been newely
diagnosed with locked in syndrome.

● Shawn lives in a one story apartment with his wife and 2 kids, they are very supportive
towards him.

● Shawn is experiencing full paralysis but has consciousness and working cognitive
abilities as well as the ability for eye movements and hearing.

● Shawn currently has a Gastronomy and Tracheotomy tubes which help him eat and
breath.

● Shawn is currently being treated in the hospital and is working towards being
discharged.

● Shawn is only able to communicate via blinking, he is also able to hear and comprehend
anything that is spoken or shown to him. As well as he can move his head.

● We have started simple with a head up for yes and head down for no and we would use
only simplistic yes or no questions when speaking to him.

● work towards using a system called the P300 which is a brain computer interface which
would allow Shawn to write words and sentences with only his brainwaves.

● The next treatment session for Shawn he will be working on using his new electric
wheelchair and on working with the P300 brain equipement.
 References

Gruber,C., Spataro,R., Allison,B., Heilinger,A., Ortner,R., Woosang,Cho.,Vincenzo L.

( 2014,June 4th). https://kids.frontiersin.org/articles/10.3

Locked in Syndrome.( 2022, March 3rd).

https://my.clevelandclinic.org/health/diseases/22462-locked-in-syndrome-lis#:~:text=Some%20p
eople%20with%20locked%2Din%20syndrome%20don%27t%20live%20beyond,a%20good%20
quality%20of%20life.

Speech Therapy Centres. (n.d.) www.speechtherapycentres.com

Adults with Developmental Disabilities Services. (n.d.)

https://www.durham.ca/en/living-here/adults-with-developmental-disabilities---services.as
px

Motion Cares. (n.d.) https://www.motioncares.ca/location/whitby/