Unusual spontaneous movements in brain-dead patients

Striking arm movements are described in five brain-dead patients. The arms flex quickly to the chest from the patient's side, the shoulders adduct, and in some patients, the hands cross or oppose just below the chin. The limbs then return to the patient's side, sometimes asymmetrically. These movements are precipitated after several minutes by hypoxia or ischemia when the ventilator is removed terminally, or during apnea testing. Families of brain-dead patients should be dissuaded from remaining in the room with the patient after the ventilator is turned off.