Diagnosis of brain death in children.

During the last two decades, criteria have been developed for the diagnosis of brain death that are applicable to adults and children over 5 years of age. To identify brain death, EEG and evoked potentials (EPs) have been extensively used as diagnostic tools in conjunction with the clinical examination and other laboratory procedures such as four-vessel cerebral angiograms or radionuclide scans. In this report, we review the criteria for the determination of brain death. In addition, the question of applying these criteria to children under 5 years of age is critically assessed, with special emphasis on the role of EEG and EPs in confirming the cessation of all brain activities. We propose that the criteria that pertain to adults may be appropriate for children under 5 years of age as well; however, this premise needs to be validated by a large nationwide multi-institutional study.