Monsieur Noirtier was sitting in a wheelchair, in front of a large mirror, so that without attempting to move, which would have been impossible, he could see the whole apartment. Motionless as a corpse, he greeted his children with bright intelligent eyes . . .

Sight and hearing were the only senses remaining; and it was only by means of one of these that he could reveal the thoughts and feelings that still occupied his mind . . . and although the movement of the arm, the sound of the voice, and the agility of the body, were wanting, the speaking eye sufficed for all, and was the medium through which his thoughts were conveyed.

He was like a corpse with living eyes, and only three persons could understand the language of the poor paralytic . . . . It was understood that when the old man meant “yes” he would close his eyes, when he meant “no” he would blink several times, and if he needed something he would raise them to heaven. If he wanted Valentine, he closed his right eye only, and if Barrois, the left. At Madame de Villefort's suggestion he blinked vigorously . . . .

Freely abridged from The Count of Monte Cristo by Alexandre Dumas, pére

In this passage the author offers a perfect description of the locked-in syndrome, a rare neurologic condition in which the patient is conscious but cannot move or communicate because all voluntary muscles of the body are paralyzed except for the eyes. The condition is caused by damage to a specific part of the brainstem (pons), most commonly by a stroke, trauma, or drug overdose.

 


 George Dunea, MD, Editor-in-Chief