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Related Experiment Videos

Pyramidal tract function during onset of brain death.

R Firsching1, S Wilhelms, G Cséscei

  • 1Klinik für Neurochirurgie, Universität zu Köln, Cologne, F.R.G.

Electroencephalography and Clinical Neurophysiology
|July 1, 1992
PubMed
Summary

Transcranial magnetic evoked potentials (TMEPs) and somatosensory evoked potentials (SEPs) show promise in assessing brain death. TMEPs were consistently absent in brain death patients, aiding diagnosis.

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Diagnostic Tools

Background:

  • Brain death diagnosis relies on clinical criteria and apnea testing.
  • Evoked potentials can assess neural pathway integrity.
  • Non-invasive methods are crucial for accurate brain death determination.

Purpose of the Study:

  • To evaluate the utility of transcranial magnetic evoked potentials (TMEPs) and somatosensory evoked potentials (SEPs) in diagnosing brain death.
  • To compare TMEPs and SEPs in patients with primary brain lesions meeting brain death criteria.

Main Methods:

  • Sequential recording of TMEPs and SEPs in 51 patients with primary brain lesions meeting brain death criteria.
  • Assessment of TMEPs and cortical SEPs in relation to coma grade and apnea testing.

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  • Comparison of preserved responses after cervical magnetic and somatosensory stimulation.

    • Main Results:

    • TMEPs were unobtainable in all patients meeting brain death criteria, even when apnea was noted.
    • Cortical SEPs were absent in patients with apnea and cranial nerve areflexia.
    • Cervical somatosensory responses were preserved in 44% of these patients.
    • In deteriorating patients (Coma Grade III), TMEPs were present in 3 instances while cortical SEPs were absent.

    Conclusions:

    • TMEPs appear to be a reliable, non-invasive tool for assessing brain death, consistently absent when apnea is present.
    • While cortical SEPs can be absent, preserved cervical responses indicate potential for further investigation.
    • TMEPs show potential as an adjunct to current brain death criteria, particularly in challenging cases.