Reflex and Spontaneous Movements of Patients in the Process of Determining Brain Death
- Author:
Young Soo KIM
1
;
Juhyeon KIM
;
Oh Young KWON
;
Minhwa KIM
;
Jeongrim LEE
;
Wonhyun CHO
;
Do Hyung KIM
;
Tae Won YANG
;
Soo Kyoung KIM
Author Information
- Publication Type:Review
- Keywords: Brain death; Movement; Reflex
- MeSH: Brain Death; Brain Stem; Brain; Cohort Studies; Diagnosis; Humans; Motor Cortex; Neurologic Examination; Reflex; Spinal Cord
- From:Journal of the Korean Neurological Association 2019;37(4):345-351
- CountryRepublic of Korea
- Language:Korean
- Abstract: Brain death is a clinical diagnosis that implies irreversible loss of function of the entire brain, including the brainstem and both hemispheres. It is not uncommon for reflex and spontaneous movements to occur in patients with impending brain death during the process of determining brain death. When physicians charged with judging brain death witness such movements during this period, unless they know how common these movements are and what they mean, it will be difficult for them to make an appropriate determination of brain death. Movements following brain death have been reported in previous studies of various types, including cohort studies and case series or reports. However, only a few studies have employed verified diagnostic tools and neurological examinations as a standard protocol when diagnosing brain death. According to previous reports, the frequency of these movements ranges from 19.2% to 75.0% of all brain death cases. These reports have also described which movements are commonly seen. However, it is difficult to determine conclusively where these movements originate, i.e., in the spinal cord or in the cerebral motor cortex, and how such information should be considered in determining brain death. Although limited information is available on the characteristics and pathophysiological mechanism of these movements, it will help physicians to diagnose brain death correctly if they obtain sufficient knowledge about them.
