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

According to the recommendations of the medical board of the FRG the clinical diagnosis of cerebral death in adults requires an observation period of 12 hours. Evoked cerebral potentials have been accepted as a technical method of confirmation of clinical signs. In 32 patients with the signs of apneic brain-stem areflexia acoustic evoked brain-stem potentials and median-evoked somatosensory potentials were recorded. In supratentorial lesions evoked potentials are adequate to confirm complete cessation of brain function. In three cases of primary brain-stem disease evoked potentials were abolished, however, unequivocal EEG activity was preserved. The registration of evoked potentials is sufficient to confirm the brain death syndrome in primary supratentorial lesions, in infratentorial disease, however, demonstration of isoelectric EEG is necessary.