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Movements in brain death: a systematic review.

Gustavo Saposnik¹, Vincenzo S Basile, G Bryan Young

¹Division of Neurology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques

|April 22, 2009

Summary

Spinal reflexes can occur in brain death cases, challenging diagnosis. Awareness of these movements is crucial for clinicians, as they do not rule out brain death or organ donation.

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Area of Science:

Neurology
Forensic Medicine

Background:

Brain death signifies irreversible loss of all brain function.
Neurological determination of death can be complicated by spontaneous or reflex movements.

Observation:

A review of 131 articles (1960-2007) examined movements in brain-dead individuals.
Observed movements included plantar withdrawal, muscle stretch reflexes, and Lazarus's sign.

Findings:

Most described movements are considered spinal reflexes.
These reflexes occur in up to 40-50% of heart-beating cadavers.

Implications:

Clinicians must recognize that these movements do not negate a brain death diagnosis.
Awareness of spinal reflexes is vital for accurate death determination and organ transplantation protocols.

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