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Subtle ocular movements in a patient with brain death
Journal article   Peer reviewed

Subtle ocular movements in a patient with brain death

D Fattal, J McDaniel, E C Leira and G A Schmidt
Journal of stroke and cerebrovascular diseases, Vol.29(9), p.104913
09/2020
DOI: 10.1016/j.jstrokecerebrovasdis.2020.104913
PMID: 32807410

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Abstract

Introduction and Case Presentation: Brain death can be associated with limb movements that are attributed to spinal reflexes. Although head/face movements have been rarely reported, no case of overt eye movements in brain death has been documented. We report a case of a patient with subtle eye movements whose exam was otherwise consistent with brain death. The presence of eye movements delayed pronouncing the patient as brain dead and delayed organ donation. We agree with American Academy of Neurology Position statement from 2019 that brain death does not mean demise of every neuron. Discussion: This case raises important questions about the types of movements that should be “allowed” during the determination of brain death to avoid delays in diagnosis.
Critical Care brain death/diagnosis eye movements tissue and organ procurement practice guidelines as topic/standards reflex/physiology

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