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Jerry M. Belsh, MD
Department of Neurology Division of Clinical Neurophysiology

Philip L. Schiffman, MD
Department of Medicine Division of Pulmonary and Critical Care Medicine University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School New Brunswick, NJ 08903

Arch Neurol. 1989;46(6):601-602.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The article by Grigg et al in a recent issue of the ARCHIVES concluded that the electroencephalogram (EEG) may be a poor confirmatory test for brain death because widespread EEG activity was found in the records of 19.6% of 56 consecutive patients clinically diagnosed as brain dead.

We are concerned that the authors' methods for determining apnea were inadequate. Hence, we question whether all, or even most, of their patients met "stringent clinical criteria for brain death," as claimed.

Documentation of apnea (indicating absence of the brain-stem respiratory reflex) has always been an essential part of the clinical examination of the suspected brain-dead patient. The authors' clinical criteria for brain death were based principally on the report of the President's Commission on determination of death² and the brain-death code of the United Kingdom.³ Both of these reports recommend formal apnea tests with 10-minute disconnection times . . . [Full Text PDF of this Article]

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