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Editor,—Locked-in syndrome is a rare paralytic state in which voluntary movements are affected. This uncommon de-efferent state results in quadriplegia, loss of gestural or vocal communication with a defect in horizontal eye movements. However, consciousness and vertical eye movements are spared, which enable the patient to communicate by way of ocular movement, either conjugate upward or downward.
Here, we report an unusual case of locked-in syndrome presenting disconjugate vertical and torsional ocular movement, mimicking seesaw nystagmus (SSN).
A 30 year old man was brought to the emergency room. He was unable to move his extremities at all. Verbal communication was not possible because he could not speak. Increased deep tendon reflex with bilateral extensor toe signs were noted. He could open his eyes. Visual acuity was uncheckable. Visual field appeared to be normal by a threatening test. Pupil size was equal and light reflex was …
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