Col Beant Singh(Rtd)ਕਰਨਲ ਬੇਅੰਤ ਸਿੰਘ(ਰਿਟਾ:)

My deepest respect to Col Anurag and his family. A person who has served the nation deserves the very best care, support and rehabilitation that modern medicine can offer. Locked-in syndrome is one of the most devastating neurological conditions. Col Anurag is conscious and aware, but is unable to speak or move most muscles. I understand why the family is asking: “Is there anything more that can be done?” The honest answer is: There is currently no medicine or injection proven to reverse established locked-in syndrome. But that does NOT mean that nothing can be done. Even after 13 months, I would strongly recommend assessment at a specialised centre with experience in long-term neurorehabilitation and assistive technology. Important interventions include: 1. Detailed reassessment by a multidisciplinary team A neurologist, rehabilitation physician, physiotherapist, occupational therapist, speech/swallow therapist, respiratory therapist, psychologist and specialist nurses should reassess him periodically. It is important to look carefully for even small voluntary movements that may have been missed or may have emerged over time. 2. Intensive, individualized neurorehabilitation Regular physiotherapy should focus on maintaining joint mobility, preventing contractures, improving head/trunk control, sitting tolerance and any residual voluntary movement. Even a small movement of a finger, thumb, head or eye can sometimes become functionally very important. 3. Communication should be a top priority If eye movements are preserved, an eye-gaze or eye tracking communication system can allow the person to communicate independently with family and healthcare professionals, use a computer and potentially access the internet. Simple low-tech communication methods should also be optimized. Restoring a reliable means of communication can dramatically improve autonomy and quality of life. 4. Speech and swallowing rehabilitation Periodic reassessment of swallowing and bulbar function is important. Some patients can recover partial swallowing or other bulbar functions. Speech-language therapy should continue whenever there is potential for improvement. 5. Respiratory rehabilitation Chest physiotherapy, respiratory exercises, secretion management and periodic reassessment of ventilatory requirements are essential. Preventing aspiration and chest infections is extremely important. 6. Mental health and quality of life Never assume that a person with locked-in syndrome does not understand what is happening around them. What about newer technologies? There is exciting ongoing research into: 1. Eye-tracking and advanced communication systems 2. Brain-computer interfaces (BCI) that translate brain signals into computer commands 3. BCI-assisted communication for people with severe paralysis 4. Robotics and functional electrical stimulation 5. Virtual reality and technology-assisted rehabilitation 6. Non-invasive brain stimulation, such as transcranial direct current stimulation, currently being explored as an adjunct to rehabilitation. These technologies are promising, but it is important to be realistic: most are not yet proven treatments capable of reliably reversing locked-in syndrome. ▶️A recent report in 2026 described eye-tracker-assisted communication as part of multidisciplinary rehabilitation in locked-in syndrome, with improvement in communication and psychosocial adaptation. ▶️Research into brain-computer interfaces is also progressing rapidly, particularly to restore communication and interaction for people with severe paralysis. ▶️Importantly, recovery from locked-in syndrome is not always confined to the first few months. While major recovery becomes less likely with time, some patients have shown meaningful improvement over many months and even longer. ▶️The extent of recovery depends greatly on the cause, location and severity of brain injury and whether the syndrome is complete or incomplete. For a man who has served our country, we owe him continued care, respect and access to every evidence-based opportunity for rehabilitation🙏 There may not be a miracle medicine today. But there is still meaningful medicine to be practiced and meaningful hope to be offered. Dr Sudhir Kumar @hyderabaddoctor