Beckmann Yesim, Çiftçi Yeliz, Incesu Tülay Kurt, Seçil Yaprak, Akhan Galip
Department of Neurology, Atatürk Training and Research Hospital, Faculty of Medicine, Izmir Katip Celebi University, İzmir, Turkey,
Acta Neurol Belg. 2014 Dec;114(4):303-6. doi: 10.1007/s13760-014-0284-0. Epub 2014 Mar 7.
Spontaneous and reflex movements have been described in brain death and these unusual movements might cause uncertainties in diagnosis. In this study we evaluated the presence of spinal reflexes in patients who fulfilled the criteria for brain death. Thirty-two (22 %) of 144 patients presented unexpected motor movements spontaneously or during examinations. These patients exhibited the following signs: undulating toe, increased deep tendon reflexes, plantar responses, Lazarus sign, flexion-withdrawal reflex, facial myokymia, neck-arm flexion, finger jerks and fasciculations. In comparison, there were no significant differences in age, sex, etiology of brain death and hemodynamic laboratory findings in patients with and without reflex motor movement. Spinal reflexes should be well recognized by physicians and it should be born in mind that brain death can be determined in the presence of spinal reflexes.
脑死亡患者曾有过自发和反射性运动的描述，这些异常运动可能会给诊断带来不确定性。在本研究中，我们评估了符合脑死亡标准的患者中脊髓反射的存在情况。144例患者中有32例（22%）在自发状态或检查过程中出现意外的运动。这些患者表现出以下体征：脚趾波动、深部腱反射增强、跖反射、拉撒路征、屈肌退缩反射、面部肌束震颤、颈臂屈曲、手指抽搐和肌束颤动。相比之下，有反射性运动和无反射性运动的患者在年龄、性别、脑死亡病因和血液动力学实验室检查结果方面无显著差异。医生应充分认识脊髓反射，并且应牢记在存在脊髓反射的情况下仍可判定脑死亡。
