X-Message-Number: 13078 Date: Mon, 10 Jan 2000 20:41:43 -0500 From: Jan Coetzee <> Subject: Movements common in brain-dead patients Movements common in brain-dead patients By Merritt McKinney NEW YORK, Jan 10 (Reuters Health) -- Even after being declared brain dead, nearly 40% of patients make spontaneous movements such as jerking their fingers and toes, report Argentinean researchers. While these movements may seem like signs of recovery, they are reflexes triggered by the spinal cord, not the brain, and should not give false hope to families and doctors, one of the study team told Reuters Health. Despite these movements, the patients are brain dead and will not recover, according to Dr. Jose A. Bueri of the J.M. Ramos Mejia Hospital in Buenos Aires, Argentina. The phenomenon of movements in brain-dead patients should not be misinterpreted as a sign of life, nor used to delay removal of organs for transplant, the study authors advise. ``Time should not be wasted if there is a possibility of organ donation,'' Bueri told Reuters Health. Brain death ``is the irreversible loss of function of the brain,'' the researchers note. The brain loses the ability to control vital functions such as breathing, even though the heart may continue to beat for a while. Sometimes a person who is brain dead may be connected to a ventilator to maintain breathing. During this time, family members may decide to donate the organs of the brain-dead person to patients awaiting transplants. It has been known that jerky movements sometimes occur after the brain dies, but exactly how often this phenomenon occurs was unknown, Bueri and his colleagues note in the January issue of the journal Neurology. During the 18-month study, the researchers studied 38 people who had been declared brain dead. Fifteen of the patients made movements, with jerky finger movements being the most common type. Some of the movements were spontaneous, while others appeared to be responses to touch. All of the movements began within the first 24 hours after brain death, but none continued past 72 hours, according to the report. Testing did not detect brain activity in any of the patients who made such movements after a diagnosis of brain death. Another report in the same issue of the journal documents unusual movements in two brain-dead patients. Dr. Joan Marti-Fabregas and colleagues at the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain, report on a 30-year-old woman and an 11-month-old boy who were connected to a ventilator after being declared brain dead. Each time the ventilator inflated their lungs, the patients would straighten their arms, bend their wrists and curl up their fingers. In both cases, tests proved that there was no brain activity. ``The living cells that were ordering these muscles to move were not brain cells or brain stem cells, but cells located in the spinal cord,'' Marti-Fabregas said in a press release. ''It's important for family members and healthcare professionals to be aware of this possibility.'' SOURCE: Neurology 2000;54:221-223, 224-227. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=13078