Spinal reflexes in brain death
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Spontaneous and reflex movements have been described in brain death and these unusual movements might cause uncertainties in diagnosis. In this study we evaluated the presence of spinal reflexes in patients who fulfilled the criteria for brain death. Thirty-two (22 %) of 144 patients presented unexpected motor movements spontaneously or during examinations. These patients exhibited the following signs: undulating toe, increased deep tendon reflexes, plantar responses, Lazarus sign, flexion-withdrawal reflex, facial myokymia, neck-arm flexion, finger jerks and fasciculations. In comparison, there were no significant differences in age, sex, etiology of brain death and hemodynamic laboratory findings in patients with and without reflex motor movement. Spinal reflexes should be well recognized by physicians and it should be born in mind that brain death can be determined in the presence of spinal reflexes.
KeywordsBrain death Spinal reflexes Spontaneous movements Spinal cord Coma Lazarus sign
We did not receive any financial support for this study.
Conflict of interest
The authors Yesim Beckmann, Yeliz Çiftçi, Tülay Kurt İncesu, Yaprak Seçil, Galip Akhan declare no conflict of interest in relation to this article.
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