Skip to main content
Log in

The complete apallic syndrome — a case report

  • Case Reports
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

In six patients with apallic syndrome the EEG was isoelectric, although the patients were breathing spontaneously and vegetative functions remained stable for a long period of time. No cortical somatosensory evoked potentials could be recorded in four of the patients examined. Cranial CT performed in three patients revealed extensive hypodensity of the cortex, whereas the brain stem showed no major damage. This syndrome is labelled a “complete apallic syndrome”. None of our patients, and none of the 23 patients described in the literature, recovered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Amann E, Gerstenbrand F, Jellinger K (1971) Schwerer Hirnschaden (apallisches Syndrom) nach Herzstillstand bei einem Kleinkind. Padiatr Padol 6:121–134

    Google Scholar 

  2. Bennett DR, Nord NM, Roberts TS, Mayor H (1971) Prolonged “survival” with flat EEG following cardiac arrest. Electroencephalogr Clin Neurophysiol 30:94

    Google Scholar 

  3. Bennett DR, Hughes JR, Korein J, Merlits JH, Sutter C (1977) Atlas of electroencephalography in coma and cerebral death. Raven Press, New York

    Google Scholar 

  4. Bricolo A, Benati A, Mazzo C, Bricolo AP (1971) Prolonged isoelectric EEG in a case of post traumatic coma. Electroencephalogr Clin Neurophysiol 31:174

    Google Scholar 

  5. Brierley JB, Adams JH, Graham DI, Simpson JA (1971) Neocortical death after cardiac arrest. Lancet II:560–565

    Google Scholar 

  6. Brunko E, Zegers de Beyl D (1987) Prognostic value of early cortical somatosensory potentials after resuscitation from cardiac arrest. Electroencephalogr Clin Neurophysiol 66:15–24

    Google Scholar 

  7. Haupt FW, Schumacher A (1988) Medianus-SEP and Prognose in der neurologischen Intensivmedizin — Eine Studie an 255 Patienten. Z EEG-EMG 19:148–151

    Google Scholar 

  8. Ingvar D, Brun A (1972) Das komplette apallische Syndrom. Arch Psychiat 215:219–239

    Google Scholar 

  9. Ingvar D, Brun A, Johannsson L, Samuelson SM (1978) Survival after severe cerebral anoxia with destruction of the cerebral cortex: the apallic syndrome. Ann NY Acad Sci 315:184–214

    Google Scholar 

  10. Jonkman EJ (1969) Cerebral death and isoelectric EEG. Electroencephaogr Clin Neurophysiol 27:215

    Google Scholar 

  11. Leenstra-Borsje H, Boonstra S (1969) A restrospective investigation of the clinical symptoms and course of patients with complete or incomplete isoelectric EEG. Electroencephalogr Clin Neurophysiol 27:214–15

    Google Scholar 

  12. Mauguiere P, Desmedt JE, Courjon J (1983) New generators of N18 and P14 somatosensory evoked potentials studied in patients with lesions of thalamus or thalamo-cortical radiations. Electroencephalogr Clin Neurophysiol 56:283–292

    Google Scholar 

  13. Pollack NA, Kellaway P (1978) Cortical death with preservation of brain stem functions, correlation of clinical, electrophysiologic, CT-scan findings in 3 infants and two adults with prolonged survival. Transam Neurol Assoc 103:36–38

    Google Scholar 

  14. Schara J (1976) Die Grenzen der Behandlungspflicht in der Intensivmedizin. Dtsch Ärztebl 73:507–515, 587–591

    Google Scholar 

  15. Schuchardt V, Biniek R, Heitmann R (1984) Grenzen neurologischer Intensivmedizin. Intensivther Notfallmed 19:65–70

    Google Scholar 

  16. Schwartz BA (1970) Non existent or imperceptible EEG activity. Electroencephalogr Clin Neurophysiol 29:531

    Google Scholar 

  17. Trojaberg B, Jorgenson EO (1973) Evoked cortical potentials in patients with isoelectrical EEGs. Electroencephalogr Clin Neurophysiol 35:301–309

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Biniek, R., Ferbert, A., Rimpel, J. et al. The complete apallic syndrome — a case report. Intensive Care Med 15, 212–215 (1989). https://doi.org/10.1007/BF01058577

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01058577

Key words

Navigation