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June 1989

Clear Thinking, Electroencephalography, and Brain Death

Author Affiliations

Department of Neurology The Mount Sinai Medical Center One Gustave L. Levy PI New York, NY 10029

Arch Neurol. 1989;46(6):601. doi:10.1001/archneur.1989.00520420019005

To the Editor.  —Grigg et al1 in the September 1987 issue of the Archives cast doubt on the usefulness of the electroencephalogram as a confirmatory test of brain death. The acceptance of brain death as a final event by relatives is, in part, dependent on the medical profession's acceptance of brain death as death.2The criteria of Grigg et al and their use of the term "brain death" constitute a shift from the American use of the term to the British. The American criteria of death, as proposed by the President's Commission,3 include "irreversible cessation of all functions of the entire brain, including the brain stem." This is a state and is independent of diagnosis. Grigg et al include a primary cause of coma as part of their criteria, as do the British.4The testing of brain-stem function can diagnose brain-stem death but not brain death.

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