To the Editor.
—Brain death is defined as a state of total absence of function of the brain.1 Adopting this definition one might ask whether electrical activity derived from the scalp of a dying patient is a function of the brain or not. This underscores the need for a clear distinction of what special function has been evaluated by which means. Clinical diagnosis of brain-stem death rests on the knowledge of the primary cause of the coma and the abolishment of brain-stem reactivity. Technical investigations undertaken to confirm the diagnosis of brain death may, of course, yield seemingly contradictory results. Everybody who is engaged in determining brain death has noted an isoelectric electroencephalographic (EEG) recording before, as well as electrical brain activity after, the clinical diagnosis has been made. It has been pointed out that EEG silence may lag behind clinical signs of brain death from 1 to 8
Lang CJG. EEG Activity After Brain Death? Arch Neurol. 1989;46(6):602. doi:10.1001/archneur.1989.00520420020007
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