CLINICAL, PHYSIOLOGICAL, AND PATHOLOGICAL EVIDENCE TER VAGUS DYSFUNCTION IN A CASE OF TRAUMATIC BRAIN INJURY

A trauma victim with locked-in syndrome demonstrated severely decrease d bowel sounds, intact response to suppository, and elevated, but unch anging pulse, Absent cardiac response to tracheal suctioning, high gas tric residual volumes, and pulmonary edema in response to a urecholine challenge demonstrated dysfunction in the autonomic system, Symptoms persisted for 21/2 years until death, At autopsy, asymmetric bilateral involvement of the dorsal motor nucleus of the vagus and of the nerve tract in the medulla were demonstrated, In contrast, a control subjec t with locked-in syndrome caused by a stroke did not demonstrate these phenomenon, In trauma patients with delayed gastric emptying, measure ment of the heart rate response to deep suctioning may lead to the dia gnosis of this vagus dysfunction syndrome.