He was taken to the Neuro Critical Care Unit at Addenbrooke's hospital in Cambridge, England, where he was initially able to talk. But after an infection and organ failure, he slipped into a coma.
The family wanted treatment discontinued, remembering Rudd had told them after a friend's paralysis: "If ever this happens to me, I don't want to go on. I don't want to be like him."
Menon spent three weeks working with Rudd to help him understand his condition.
"He was not communicating with us," he said. "His imaging and clinical picture and prognosis looked bleak and he was not making any progress."
Doctors weren't sure what his cognitive ability was, even after Rudd began blinking.
"His case was not so clear cut," Menon said. "It was difficult to know."
So Menon began a step-by-step process to see if Rudd could respond to commands, develop a vocabulary and syntax and communicate using those eye movements.
Finally, Menon said, they were confident Rudd could communicate well enough to make the decision himself -- he didn't want to die.
His father, also Richard Rudd, said this week that the family was convinced there was "no way in a million years" that their son would want to live with such devastating injuries, according to Britain's Daily Mail newspaper.
"When we are healthy and in good condition, it's easy to say you would want to be switched off but when it actually happens it's completely different," he said.
"Making a living will could be detrimental to your own health. Imagine if you changed your mind but couldn't communicate it," said Rudd's father. "For my part, I'm glad he's alive and didn't make a living will. If he had, then we would never have known whether it was worth continuing with the treatment."
A living will is a document that states whether a person wants to be kept on life support if they become terminally ill or are in a persistent vegetative state. It can also address other issues such as tube feeding, artificial hydration and pain medication.
Doctors only invoke the living will when a patient cannot communicate on his or her own.
Despite Rudd's change of heart, following a living will is the best choice families have when their loved ones can't communicate, according to Stuart Youngner, chairman of the department of bioethics at Case Western Reserve School of Medicine in Ohio.
"Keeping a person alive against his will is a terrible choice," he said. "If you can't follow a living will, you doom many people who feel tortured to be kept alive in that state. If we take living wills seriously, we can't have it both ways."
Youngner said locked-in syndrome is "one of the top things I never want to happen to me."
"To an outside observer it's as if you are unconscious and in a coma," he said. "Your eyes are closed, you don't respond to pain. You can be fully awake and alert. The worst part is when nobody knows you are in there and think you are unconscious and do things like speak in front of you while you are lying their helpless, paralyzed and unable to communicate."
But living wills are only a guide, according to R. Alta Charo, professor of law and medical ethics at the University of Wisconsin-Madison.