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Spontaneous and reflex movements in brain death.
G Saposnik1, J A Bueri, J Mauriño
1Department of Neurology, Hospital J.M. Ramos Mejía, Buenos Aires, Argentina.
Neurology
|January 15, 2000
Summary
Spontaneous and reflex movements are observed in some patients diagnosed with brain death (BD). These movements, including finger jerks, do not rule out a brain death diagnosis.
Area of Science:
- Neurology
- Neuroscience
- Critical Care Medicine
Background:
- Spontaneous and reflex movements can occur in patients with brain death (BD).
- The frequency and types of these movements are not well-documented.
- Distinguishing these movements from signs of potential recovery is crucial.
Purpose of the Study:
- To prospectively evaluate the frequency of spontaneous and reflex movements in patients meeting brain death criteria.
- To document the types of movements observed.
- To determine if these movements impact the diagnosis of brain death.
Main Methods:
- Prospective evaluation of 38 patients fulfilling brain death criteria.
- Utilized a standardized protocol to observe and record movements.
- Documented specific types of spontaneous and reflex movements.
Main Results:
- 15 out of 38 patients (39%) exhibited spontaneous or reflex movements.
- The most frequent movement observed was finger jerks.
- Other observed movements included undulating toe flexion, triple flexion response, Lazarus sign, pronation-extension reflex, and facial myokymia.
Conclusions:
- Spontaneous and reflex movements are more common in brain death than previously reported.
- The presence of these movements does not exclude a diagnosis of brain death.
- Clinical vigilance is required to correctly interpret these movements in the context of brain death evaluation.