[Totally paralyzed or brain dead?].
In two patients, men aged 23 and 42 years, a condition that mimicked brain death was observed as a consequence of rapidly progressive complete peripheral paralyses, which included the intrinsic and extrinsic eye muscles. However, the EEG revealed a waking pattern. Maximal supportive therapy was provided, which included haemodialysis for the first patient and artificial ventilation for both patients. A slow recovery was seen after four weeks. The first patient was paralyzed following the ingestion of a large quantity of ethylene glycol and the second by botulism due to the consumption of injudiciously canned food. In patients with catastrophic brain injury, the diagnosis of brain death can be confirmed by a clinical neurological examination. In considering the diagnosis 'brain death', the most important criterion is that the cause of the brain damage is established. If the cause is insufficiently, the presence of brain death should be seriously doubted, unless an isoelectric EEG is observed.
van Dijk
G W
GW
Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht. g.w.dijk@neuro.azu.nl
Vos
P E
PE
Eurelings
M
M
Jansen
G H
GH
van Gijn
J
J
D000328:Adult; D001906:Botulism / Q000175:diagnosis* / Q000382:microbiology; D001921:Brain / Q000503:physiopathology; D001926:Brain Death / Q000175:diagnosis* / Q000503:physiopathology; D002129:Calcium Oxalate / Q000652:urine; D002493:Central Nervous System Diseases / Q000139:chemically induced* / Q000382:microbiology*; D003014:Clostridium botulinum / Q000302:isolation & purification; D003937:Diagnosis, Differential; D004569:Electroencephalography; D019855:Ethylene Glycol / Q000506:poisoning*; D005519:Food Preservation; D006801:Humans; D008297:Male; D011782:Quadriplegia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function
D002129:Calcium Oxalate; D019855:Ethylene Glycol