| Electroencephalography for the diagnosis of brain death
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| Seo-Young Lee1, Won-Joo Kim2, Jae Moon Kim3, Juhan Kim4, Soochul Park5, and on behalf of the Korean Society of Clinical Neurophysiology Education Committee |
1Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
2Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
3Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
4Department of Neurology, Hanyang University Seoul Hospital, Seoul, Korea
5Department of Neurology, Yonsei University College of Medicine, Seoul, Korea |
| Corresponding Author:
on behalf of the Korean Society of Clinical Neurophysiology Education Committee ,Tel: +82-2-2291-2290 , Fax: +82-2-737-6531 , Email: kscn@kscn.or.kr |
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Received April 27, 2017 Revised: May 31, 2017 Accepted June 7, 2017 |
| Copyright © 2017 The Korean Society of Clinical Neurophysiology |
| This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium,
provided the original work is properly cited. |
| ABSTRACT |
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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. |
| Key words:
Electroencephalography; Brain death; Electrocerebral inactivity |
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