To the Editor.
—Grigg et al1 reported in the September 1987 issue of the Archives the phenomenon of persistent electroencephalographic (EEG) activity following "brain death."1 Their conclusion, that EEG is of questionable value as a confirmatory test of brain death, is not completely supported by the data presented. For example, of 11 patients in whom EEG activity persisted after brain death, only 6 had undergone radionucleotide cerebral perfusion scans to confirm brain death. In fact, one such scan revealed good cerebral flow. Therefore, in 5 patients, the only measure of the validity of EEG in the confirmation of brain death was the bedside examination. The validity of a confirmatory test (ie, EEG) cannot be assessed by the very entity that needs to be confirmed. Rather, a confirmatory test must be compared with another test of equal or better specificity, such as angiography or radionucleotide cerebral perfusion scanning.The lack
De Giorgio CM. The Value of the EEG in Determining Brain Death. Arch Neurol. 1989;46(6):602–603. doi:10.1001/archneur.1989.00520420020008