Yawning despite trismus in a patient with locked-in syndrome caused by a thrombosed megadolichobasilar artery

Clin Neurol Neurosurg. 2003 Dec;106(1):44-6. doi: 10.1016/s0303-8467(03)00045-3.

Abstract

We report a 62-year-old woman with a locked-in syndrome with bilateral masticatory spasms and persistent trismus, who was still able to yawn. A vascular malformation of the basilar artery-megadolichobasilar artery (fusiform aneurysm, vertebrobasilar dolichoectasia) was determined to be the underlying cause of this rare combination of symptoms. A thrombus in the megadolichobasilaris as well as an almost total pontine infarction were demonstrated on CT- and MRI-scans. Thus, trismus may be associated with locked-in syndrome due to megadolichobasilar artery thrombus, although yawning is still possible.

Publication types

  • Case Reports

MeSH terms

  • Brain Stem / physiopathology
  • Brain Stem Infarctions / complications*
  • Brain Stem Infarctions / diagnosis
  • Brain Stem Infarctions / physiopathology
  • Dilatation, Pathologic / complications
  • Dilatation, Pathologic / diagnosis
  • Dilatation, Pathologic / physiopathology
  • Dominance, Cerebral / physiology
  • Female
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / physiopathology
  • Intracranial Embolism / complications*
  • Intracranial Embolism / diagnosis
  • Intracranial Embolism / physiopathology
  • Magnetic Resonance Imaging
  • Middle Aged
  • Nerve Net / physiopathology
  • Neurologic Examination
  • Pons / blood supply*
  • Quadriplegia / etiology
  • Quadriplegia / physiopathology*
  • Tomography, X-Ray Computed
  • Trismus / physiopathology*
  • Yawning / physiology*