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Electroencephalography for the diagnosis of brain death

Authors
 Seo-Young Lee  ;  Won-Joo Kim  ;  Jae Moon Kim  ;  Juhan Kim  ;  Soochul Park  ;  Korean Society of Clinical Neurophysiology Education Committee 
Citation
 Journal of the Korean Society for Clinical Neurophysiology (대한임상신경생리학회지), Vol.19(2) : 118-124, 2017 
Journal Title
 Journal of the Korean Society for Clinical Neurophysiology (대한임상신경생리학회지) 
ISSN
 1229-6414 
Issue Date
2017
Keywords
Electroencephalography ; Brain death ; Electrocerebral inactivity
Abstract
Electroencephalography (EEG) is frequently used to assist the diagnosis of brain death. However, to date there have been no guidelines in terms of EEG criteria for determining brain death in Korea, despite EEG being mandatory. The purpose of this review is to provide an update on the evidence and controversies with regarding to the utilization of EEG for determining brain death and to serve as a cornerstone for the development of future guidelines. To determine brain death, electrocerebral inactivity (ECI) should be demonstrated on EEG at a sensitivity of 2 μV/mm using double-distance electrodes spaced 10 centimeters or more apart from each other for at least 30 minutes, with intense somatosensory or audiovisual stimuli. ECI should be also verified by checking the integrity of the system. Additional monitoring is needed if extracerebral potentials cannot be eliminated. Interpreting EEG at high sensitivities, which is required for the diagnosis of brain death, can pose a diagnostic challenge. Furthermore, EEG is affected by physiologic variables and drugs. However, no consensus exists as to the minimal requirements for blood pressure, oxygen saturation, and body temperature during the EEG recording itself, the minimal time for observation after the brain injury or rewarming from hypothermia, and how to determine brain death when the findings of ECI is equivocal. Therefore, there is a strong need to establish detailed guidelines for performing EEG to determine brain death.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161596
DOI
10.14253/acn.2017.19.2.118
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실)
Yonsei Authors
김원주(Kim, Won Joo) ; 박수철(Park, Soo Chul)
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