Brain Re-Ignition and Recovery After Coma and Flat Line Brain Death
Can the Brain Dead Come Back to Life?
Medical science has found that some patients languishing in a coma can revive after reaching "flat line" EEG status. This recovery can occur even though the EEG has been interpreted to mean brain death. The reason for this recovery is that another coma stage exists after "flat line" and in it, the brain sparks back to life.
Brains Can Self-Start After Flat Line
The EEG "flat line" has been a standard benchmark for the official indication of death, even when other organs continue to function for a short time.
During a neuroscience study in 2013, medical researchers in Montreal, Quebec discovered in their coma patients a deeper level of consciousness at which brain activity re-ignites.This was discovered along with a heretofore unrecognized brain wave that the study leaders names the "Nu complex."
Thus far, scientists feel that given the presence of Nu-complexes in a "brain dead" patient, the brain actually can come back to life.
Considering this new information as accurate and relevant, then a flat line reading is not always the last stop before expiration of the coma patient.
This knowledge may make the decision of family members or close friends as representatives of the patient's wishes to "pull the plug" at a diagnosis of brain death even more difficult than before the new data emerged.
Types of Brain Waves
In a recent study conducted by a team led by Amzica, researchers found evidence that there are still some traces of cerebral activity in irreversible coma patients.— Tony WU, Johns Hopkins News-Letter; October 2013
During autumn 2014, a man in a coma since late summer 2013 was revived with the scent of Chinese currency waved under his nose. Scents and sounds are powerful stimulants and can bring patients back from comas. These stimulants include the sound of a favorite TV program, the aroma of one's grandmother's cooking, and several others, according to the The Ohio State University College of Medicine and news.au.com on 1-13-2015.
Brain Death Challenge
Could you accept Durable Power of Attorney and remove life support of a relative or friend in a coma?
The brain may survive in deeper states of coma than the ones found during the isoelectric line (flat line).— Lead researcher, Florin Amzica.
What Is a Coma?
The Mayo Clinic, one of the most well respected medical establishments for treatment and training in America, can tell us what constitutes a coma.
The authorities at Mayo state that a coma is a state of prolonged unconsciousness and is related to any of several problematic causes. These causes are often:
- Traumatic brain injury (TBI)
- Strokes (cardiovascular events)
- Abrain tumor,
- Drug/alcohol intoxication
- Chronic illnesses such as diabetes
- Long-term infections
Levels of Coma and Their Assessment
The Calder Medical Center in Miami, Florida has replaced the most-used Glasgow Coma Scale with the Rancho Los Amigos Scale (RLAS) when a patient begins to show signs of awareness and ability to respond to his/her environment.
The RLAS is more thorough in assessment, with several additional levels of consciousness or arousal state with which to work. Level I is coma.
The eight levels that use ten elements each in this RLAS rating scale range from no response to through four levels that include types of confusion to a final "purposeful and appropriate" status of behavior.
The Glasgow Coma Scale is still used to assess coma, but may need to be revised to reflect a stage of coma that comes after the EEG flat line.
Effective Coma Assessment Scales
The Glasgow Coma Scale is shown on hundreds of sites around the Internet as a straightforward 15-point scale, but a simple addition of the points in each of the three categories of examination of brain activity is not enough to provide an accurate clinical assessment of consciousness in adults or children.
Additional Coma Assessment Scales
Newer coma rating scales have not shown high enough reliability statistics to recommend widespread usage, but these scales include:
- Blantyre coma scale
- Simplified Motor Scale
Brain Activity Found After Flat Line EEG
Researcher Amzica found evidence of brain activity after flat line resulted in not only one man, but also 26 cats in his 2013 study.
The Amzica research team found that activity in the hippocampus can transmit to the cerebral cortex after a flat lining and restore the patient to consciousness.
The team measured brain wave function of a patient that suffered cardiac arrest and revival, received drug treatment for seizures, and was in coma. Under the seizure treatments, the researchers observed a flat line EEG that was followed by EEG patterns never before recorded in the related literature.
Experiments with 26 cats found overall that an anesthetic, isoflurane, stimulated brain activity after flat line EEGs.
After EEG flat lining, anti-epileptic medication stimulated brain activity in a human comatose patient, while isoflurane produced a similar phenomenon in the experimental cats.
In the future, comatose patients may have some hope of revival after flat lining, given that adequate and safe means of treatment can be developed.
P.E.T. Scans Can Predict Who Will Wake Up
To add to the hope that coma patients have in the future, research in 2014 has found that PET scans can reveal brain activity after flat line EEGs, without the use of anesthetics or treatment drugs:
Brain scans might show which coma patients are likely to wake up. Steven Laureys. University of Liege, Belgium. The Lancet. April 2014.
Brain Injury Awareness Can Prevent Coma and Brain Death
Doctors in the United States military services and in private practices feel that it is vital to diagnose Traumatic Brain Injury (TBI) as soon as possible. This has led to concussion protocols initiated immediately in the case of football accidents and events like NASCAR race crashes.
The military is paying more attention to head injuries as well. Such protocols can reduce the possibility of coma and death in head trauma cases.
March is Brain Injury Awareness Month, especially for our military services. During this month, military medical professionals raise awareness of the TBI symptoms and the vital importance of diagnosing brain injuries.
- Kroeger. D, Bogdan, F. and Amzica, F. Human Brain Activity Patterns Beyond the Isoelectric Line of Extreme Deep Coma. PLOSone. September 18, 2013.
- Taesdale, G. and Jennett, B.J. Glasgow Coma Scale (first use). University of Glasgow, Institute of Neurological Sciences; 1974.
- Neurofeedback Alliance | Your guide to neurofeedback in Australia. Accessed March 19, 2019.
- The Ohio State University College of Medicine, Department of Neurology. The Glasgow Coma Scale. 1974 - present.
- Wu, T. Hope is found even in flat-lined EEG The Johns Hopkins News-Letter; October 2013.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2015 Patty Inglish MS