Locked-in syndrome is due to a ventral pons lesion, which deafferentiates the patient for most motor function (absent horizontal eye movements, no grimacing, no swallowing, no head movements, and no limb movements). Patients with locked-in syndrome have their eyes open, blink, and may have spontaneous vertical eye movements. A large proportion of patients die of pulmonary complications or withdrawal of support, but patients may survive for decades. Using serial videos, we were able to document that a patient with a nearly classic syndrome (but incomplete owing to some bulbar function) may improve dramatically over a prolonged period. Perhaps the presence of some oropharyngeal function early may be the prelude to recovery of speech and motor function. Imbalance due to spastic ataxia remained but most other motor functions recovered well.