A long recovery from locked-in syndrome


Initially admitted to Bath Hospital with locked-in syndrome secondary to pontine demyelination, after experiencing a fall in December 2015.

Subsequently, he had to be transferred to ITU for respiratory failure and was successfully treated for hospital acquired pneumonia. Gareth developed limb weakness and problems with his speech. He had a tracheostomy inserted. At this time, Gareth was able to understand and would communicate using his eyes, head movement and a communication board. In January 2016, he was transferred to Helena Ward in Bath hospital and other issues included mild portal hypotensive gastro-pathy, Barrett’s oesophagus and depression/anxiety.

In February 2016, Gareth was transferred to Glenside’s hospital neuro rehabilitation unit (NRU) for rehabilitation having regained some upper and lower limb strength. Once at Glenside, a care plan was developed with Gareth’s input.

The Speech and Language team worked with Gareth to get him to swallow, so he could start to eat properly again. He had his tracheostomy removed which significantly improved his situation.

The podiatry team assisted Gareth with his foot-care and liaised with the physiotherapy team regarding a possible addition to his footwear to improve the ground clearance of his right foot during the swing phase of walking.

The Physio team worked with Gareth to improve his strength, stamina and coordination progressing his independent mobility and motor function. Gareth is now able to walk for short distances unaided and aims one day to return to cycling and the other activities he enjoyed prior to his injury.

During his inpatient rehabilitation Gareth was seen by occupational therapy staff. His initial goals included being able to shower and dress independently and the ability to use his hands so he could write and enjoy other leisure interests. OT provided Gareth with equipment to enable him to shower independently, and worked with him on exercises for hand strength and coordination, enabling Gareth to join the on-site vocational clubs, run by the Activity Organisers, including breakfast group, furniture restoration and gardening group.

As Gareth’s mobility increased, he visited home with his therapists to review his walking within the home environment, identify and minimise any risks, and to check if equipment may be required to allow discharge. A home visit also enabled his therapy team to target interventions towards his specific discharge goals. Gareth has also practised getting out and about by bus with his therapists, aiming to maximise his independence for the future.

Gareth completed his rehabilitation journey with Glenside and has since returned home. He said of his time at Glenside “As soon as I came to Glenside I made progress. The Speech and Language team got me to swallow so that I could start eating again. Initially I started eating like a horse and went from 50 to 80 kilos, regaining the weight I had lost following my accident.”