title: ALS patients on TPPV: totally locked-in state, neurologic findings and ethical implications.
abstract: Seventy patients with ALS using tracheostomy positive pressure ventilation (TPPV) were evaluated for impaired communication. Severely impaired communication is divided into the totally locked-in state (TLS) and the minimal communication state (MCS). TLS occurred in 8 of 70 (11.4%). In the 33 patients on TPPV for more than 5 years, TLS developed in 6 (18.2%) and MCS in 11 (33.1%). Respiratory management for ALS allows long-term survival if mechanical ventilation is used.
authors.affiliation: Department of Neurology (Dr. Hayashi), Tokyo Metropolitan Neurological Hospital, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Edward Anthony
authors.initials: EA
authors.lastname: Oppenheimer
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002423:Cause of Death; D003147:Communication Disorders / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D015897:Comorbidity; D018450:Disease Progression; D026690:Ethics, Clinical; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011175:Positive-Pressure Respiration / Q000941:ethics*; D011782:Quadriplegia / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D015996:Survival Rate; D013995:Time; D014139:Tracheostomy