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D. Alan Shewmon, MD
Department of Pediatrics Division of Neurology UCLA School of Medicine Center for the Health Sciences 10833 LeConte Ave Los Angeles, CA 90024

Arch Neurol. 1989;46(6):603-604.

	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.

—Grigg and colleagues¹ in a past issue of the ARCHIVES have documented that electroencephalographic (EEG) activity, sometimes bearing a striking resemblance to physiologic sleep, can persist in the presence of extensive brain-stem infarcts. This is hardly surprising nor is it new information. The only really new contribution of the article is the increase in semantic confusion generated by labeling such a state "brain death."

The British, whose concepts inspired the authors, are at least some-what more attentive to terminologic exactitude. They speak of "brain-stem death," by which they mean death (destruction) of the brain stem, the relevance of which is that it indicates an invariably fatal prognosis, despite the use of aggressive life-support technology.^2,3 The main reason for wanting to diagnose this condition is to demonstrate the futility of such treatment, as a justification for withdrawing it.^3,4 "Brain-stem death" so understood is, of course . . . [Full Text PDF of this Article]

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