The Value of the EEG in Determining Brain Death

Abstract

To the Editor. —Grigg et al 1 reported in the September 1987 issue of theArchivesthe phenomenon of persistent electroencephalographic (EEG) activity following 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