Paradoxical contributions of EEG during protracted dying

Estimates of the potential for recovery from severe brain damage have become more accurate as EEG and imaging techniques evolve. When all modern electrical criteria for brain death are satisfied, useful recovery is probably impossible. Many patients who have no reasonable chance of returning to a cognitive, sapient, or useful state may be nurtured throughout a prolonged final illness primarily because of brain waves that fluctuate in the 2- to 5-microV range. The incidence of such protracted dying is unknown. We illustrate diffuse low-amplitude wave forms and regional fragments recorded from a 27-year-old woman maintained on a respirator for six months after loss of brain-stem reflexes. Considering the limited noise-signal ratio of modern equipment, popular EEG criteria for death may be prematurely rigid, prolonging death in tragic circumstances.