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[Multimodality evoked potentials and brain death. Prerequisites, findings and problems].

W F Haupt1

  • 1Universitäts-Nervenklinik, Schwerpunkt Neurologie, Köln.

Der Nervenarzt
|November 1, 1987
PubMed
Summary

Diagnosing brain death requires a 12-hour observation period. Evoked potentials confirm cessation of brain function in supratentorial lesions but require EEG confirmation for brain-stem disease.

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Area of Science:

  • Neurology
  • Neurophysiology

Background:

  • Clinical diagnosis of cerebral death in adults necessitates a 12-hour observation period per FRG medical board recommendations.
  • Evoked cerebral potentials are recognized as a technical method to corroborate clinical signs of brain death.

Observation:

  • Acoustic evoked brain-stem potentials and median-evoked somatosensory potentials were recorded in 32 patients exhibiting signs of apneic brain-stem areflexia.
  • The study investigated the utility of evoked potentials in confirming brain death across different lesion types.

Findings:

  • Evoked potentials adequately confirm the complete cessation of brain function in cases of supratentorial lesions.
  • In three patients with primary brain-stem disease, evoked potentials were abolished, yet electroencephalogram (EEG) activity remained unequivocal.

Related Experiment Videos

  • Evoked potential registration suffices for confirming brain death in primary supratentorial lesions.

    • Implications:

    • For infratentorial disease, demonstrating an isoelectric EEG is essential alongside evoked potential findings.
    • This research refines diagnostic criteria for brain death, emphasizing lesion location's impact on testing interpretation.
    • Accurate diagnosis of brain death is critical for organ donation and end-of-life care decisions.