death criteria in the United States includes: (1) no wakefulness or movements
other than spinal reflexes for a 48-hour observation period; (2) neurological
examinations at the beginning and at the end of the observation period
showing no clinical evidence of brain or brainstem functions; and (3)
either no electroencephalographic cortical activity at the time of the
neurological examination or no cerebral blood flow within the observation
period (Figure 64.1).
Cerebral blood flow study demonstrating absence of cerebral blood flow.
COMA FROM STATUS EPILEPTICUS
and generalized electroencephalographic status epilepticus may be associated
with a state of altered mental status clinically similar to coma. The
distinction is based on EEG findings. The distinction between status epilepticus
and coma is important because status epilepticus is a hyperexcitable neuronal
state that requires treatment with antiepileptic drugs, whereas coma is
a hypoexcitable neuronal state that does not require antiepileptic treatment.