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Decerebrate-like posturing with mechanical ventilation in brain death.

J Martí-Fàbregas1, A López-Navidad, F Caballero

  • 1Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. jmartif@meditex.es

Neurology
|January 15, 2000
PubMed
Summary

Complex reflexes are rare in brain death. However, two brain-dead patients exhibited upper limb movements triggered by ventilation and stimuli, persisting until ventilator disconnection.

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Area of Science:

  • Neurology
  • Neurophysiology
  • Critical Care Medicine

Background:

  • Brain death is characterized by the irreversible loss of all brain functions.
  • Spinal reflexes can sometimes persist after brain death, but complex reflexes are uncommon.

Purpose of the Study:

  • To report the rare occurrence of complex upper limb movements in brain-dead individuals.
  • To investigate the stimuli triggering these movements and their characteristics.

Main Methods:

  • Observation of two brain-dead, heart-beating cadavers.
  • Documentation of upper limb movements in response to mechanical pulmonary insufflation, superficial pressure, and noxious stimuli.

Main Results:

  • Two out of 400 brain-dead cases exhibited symmetric upper limb movements resembling decerebrate posture.

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  • These movements were triggered by mechanical ventilation and various stimuli applied to the body.
  • The movements persisted until mechanical ventilation was discontinued.

    • Conclusions:

    • Complex spinal reflexes, including decerebrate posturing, can manifest in brain death.
    • These reflexes may be triggered by external stimuli and mechanical ventilation.
    • Further research is needed to understand the neurophysiological mechanisms underlying these phenomena.