E-Pearl of the Week

Brought to you by the Resident and Fellow Section of Neurology.

Motor movements in brain death

A variety of spontaneous and reflexive movements may be seen in patients with brain death. The most common are myoclonus-like finger jerks. Others often seen are undulating toe flexion and triple flexion response. The most dramatic of these movements is the classic “Lazarus sign,” which includes flexion of the arms at the elbow, adduction of the shoulders, lifting of the arms, dystonic posturing of the hands, and crossing of the hands. Neurologists must be able to identify these movements and recognize that their presence does not preclude the determination of brain death.

Reference

Saposnik G, Bueri JA, Mauriño J, Saizar R, Garretto NS. Spontaneous and reflex movements in brain death. Neurology 2000;54:221-223.

Submitted by Aamir Hussain, M.D.

Disclosure: Dr. Hussain has nothing to disclose.

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