A number of reversible lesions of the brainstem may closely mimic irreversible brain death: Severe Guillain–Barré and Miller–Fisher syndromes Bickerstaff’s brain stem encephalitis progressive cranial nerve dysfunction associated with ataxia, coma and apnoea...
Coma Specific criteria are laid out in guidance from the AOMRCMetabolic or endocrine disturbanceCirculatory disturbanceSedative/depressant drugsHypothermia Apnoea Rare but should be actively sought if the history or clinical examination suggests their presenceSevere...
Factor Lower Limit Upper Limits Comments Temperature Disturbance 34°c - Impaired consciousness can occur below 34°c Biochemistry Disturbance - - Derangements clearly the result of brainstem death (e.g. hyponatraemia of DI) may not require correction prior to...
May complicate assessment on occasions where: Patient has received infusions of sedative drugs as part of their critical care treatment Brain injury as a result of drug-induced self-harm – especially problematic when substance unknown Possible approaches...
Test Procedure Confirmatory Response in Brainstem Death Pupillary Reflex A bright light is shone into each eye in turn. Direct and consensual reflexes should be sought Pupils are fixed and do not respond or constrict to light Corneal Reflex Cornea is brushed lightly...
