EEG guidelines in the diagnosis of brain death

Summary In France, for the determination and diagnostic validation of brain death the law requires either two EEG recordings separated by a 4-hour observation period, both showing electrocerebral inactivity; or cerebral angiography examination. Since EEG is available in most hospitals and clinics, i...

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Bibliographic Details
Published in:Neurophysiologie clinique 2015-03, Vol.45 (1), p.97-104
Main Authors: Szurhaj, W, Lamblin, M.-D, Kaminska, A, Sediri, H
Format: Article
Language:English
Subjects:
Aspects techniques
Brain death
Brain Death - diagnosis
Brain Death - legislation & jurisprudence
Brain Death - physiopathology
EEG
Electroencephalography
Electroencephalography - methods
Electroencephalography - standards
France
Humans
Infant
Mort cérébrale
Neurology
Recommandations
Recommendations
Technical aspects
Électroencéphalogramme
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Summary:Summary In France, for the determination and diagnostic validation of brain death the law requires either two EEG recordings separated by a 4-hour observation period, both showing electrocerebral inactivity; or cerebral angiography examination. Since EEG is available in most hospitals and clinics, it is often used in this indication, at the patient's bedside, especially in the context of organ donation. However, very precise methodology must be followed. The last French guidelines date back to 1989, before the development of digital EEG recording. We present the new guidelines from the Société de Neurophysiologie Clinique de Langue Française. Electrocerebral inactivity may be confirmed when a 30-minute good quality EEG recording shows complete electrocerebral silence, defined as no cerebral activity greater than 2 uV, having first ruled out the possible influence of sedative drugs, metabolic disorders or hypothermia. In the presence of sedative drugs, CT brain angiography will be the gold standard test for this diagnosis. In the newborn, the utmost caution is indicated since electrocerebral inactivity can be observed in the absence of cerebral death. In the infant, the criterion for the observation period to be respected between both EEG recordings needs to be more clearly refined.
ISSN:0987-7053
1769-7131
DOI:10.1016/j.neucli.2014.11.005