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Updated: Nov 19, 2025

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[Irreversible brain death-Part 2. Spinalization phenomena].

R W C Janzen, J Lambeck1, W Niesen2

  • 1Klinik für Neurologie und Neurophysiologie, Universitätsklinikum Freiburg, Breisacher Str. 64, 79106, Freiburg, Deutschland.

Der Nervenarzt
|February 1, 2021
PubMed
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Spinal automatisms and reflexes are common in irreversible brain death, confirming the diagnosis. This article clarifies these phenomena and distinguishes them from other conditions in patients with severe brain disorders.

Area of Science:

  • Neurology
  • Pathology

Background:

  • Spinal automatisms, reflexes, and peripheral reactions are frequently observed in patients with irreversible brain death.
  • These phenomena are often misinterpreted, leading to diagnostic challenges.

Purpose of the Study:

  • To provide a comprehensive overview of the phenomenology of irreversible brain death.
  • To discuss irreversible brain death from a neuropathological perspective.
  • To differentiate irreversible brain death from pathological movements in comatose patients.

Main Methods:

  • Literature review and synthesis of existing research on spinal automatisms and reflexes in brain death.
  • Neuropathological analysis and case study review.
  • Comparative analysis of motor reactions in brain death versus other disorders of consciousness.
Keywords:
Brain deathMotor reactionsNeuropathologyPathological movementsSpinal automatisms

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Main Results:

  • Spinal automatisms and reflexes are consistent findings in irreversible brain death.
  • These reactions are compatible with and supportive of the diagnosis of brain death.
  • Distinguishing these reactions from those seen in comatose states is crucial for accurate diagnosis.

Conclusions:

  • Spinal automatisms and reflexes are not contradictory to brain death but rather supportive evidence.
  • Understanding the neuropathological basis is key to accurate interpretation.
  • Clear diagnostic criteria are essential to avoid misdiagnosis in patients with severe brain disorders.