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Locked-In Syndrome — SCE Neurology MCQ

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ModerateCerebrovascular DiseaseLocked-In SyndromeSCE Neurology

A 62-year-old man presents with locked-in syndrome: quadriplegia, anarthria, preserved consciousness, and vertical eye movements only. MRI shows bilateral ventral pontine infarction. Which artery is occluded?

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Correct answer: E — Basilar artery

Locked-in syndrome results from bilateral ventral pontine infarction, most commonly caused by basilar artery occlusion. The ventral pons contains corticospinal and corticobulbar tracts while the dorsal pons (reticular activating system) is preserved. Vertical eye movements are preserved because the supranuclear pathway passes through the midbrain. B: PICA supplies the lateral medulla. C: AICA supplies the lateral pons. D: SCA supplies the cerebellum. E: PCA supplies the occipital lobe.

Reference: RCP National Clinical Guideline for Stroke (2023)