Brain Recovery: New Level of Coma After Flat Line - Brain Re-Ignition
Patients in a coma can revive after reaching "flat line" EEG status, even though that status has meant brain death. The reason is that there is a coma stage after "flat line" and in it, the brain sparks back to life.
Brains Self-start After Flat Line
The EEG "flat line" has been a standard accepted indicator of death, even when other organs continue to function.
However, in 2013, medical researchers in Montreal, Quebec discovered in their coma patients a deeper level of (un)consciousness at which brain activity re-ignites. Thus, a flat line is not always the last stop before expiration of the patient. This knowledge may make the decision of family members or close friends as representatives to "pull the plug" at flat line even more difficult than it already appears to be.
References for these findings:
- Daniel Kroeger, Bogdan Florea, and Florin Amzica. Human Brain Activity Patterns beyond the Isoelectric Line of Extreme Deep Coma. PLOSone. September 18, 2013
- Graham Taesdale and Bryan J. Jennett. Glasgow Coma Scale (first use). University of Glasgow, Institute of Neurological Sciences; 1974.
- The Ohio State University College of Medicine, Department of Neurology. The Glasgow Coma Scale. 1974 - present.
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. It is related to any of several problematic causes. These causes are traumatic brain injury (TBI), strokes (cardiovascular events), a brain tumor, drug or alcohol intoxication, and chronic illnesses such as diabetes and long-term infection.
Brain WavesClick thumbnail to view full-size
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 simulators and can bring patients back from comas. They include the sound of a favorite TV program, the aroma of one's grandmother's cooking, and several others.
References: 1) The Ohio State University College of Medicine; 2) news.au.com on 1-13-2015
Levels of Coma and Assessment of Them
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.
Glasgow Coma Scale and More Recent Instruments of Assessment
The Glasgow Coma Scale is shown on hundreds of sites around the Internet as a simple 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. Some examples of the most useful versions of the scale is located here for children and here for adults.
Additional 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
Electricity is Life
Brain Activity Found After Flat Line EEG
Researcher Amzica found evidence of brain activity after flat line in one man and 26 cats in his 2013 study. The team of researchers 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.
Results: 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.
Pet 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 Death Challenge
Could you accept Durable Power of Attorney and remove life support of a relative or friend in a coma?
Brain Biology and Healing
- Brain Biology - Children's Brains and Development of Frontal Lobes Prior to Adolescence
Some web information contrariwise, our brains form frontal lobes in the womb, with massive growth at 1) 35 - 40 weeks gestation and 2) infant ages 6-12 months, on average. Then, they grow more.
- Glen Campbell , Memory Loss and Traumatic Brain Injury
In private practices & rehabilitation settings, I appreciated opportunities to see many head trauma/memory patients with a treatment team. Many people regain memories and cognitive function over time.
- Open Head Brain Trauma Injury and Recovery - JFK and Gabrielle Giffords - Miracle Recovery
Arizona Representative's chances for recovery are measureable. President Kennedy's were nonexistant and the conflicting stories of physicians and others in his operating room have clouded the picture too far to be parsed.
© 2015 Patty Inglish MS