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Brain Recovery: New Level of Coma After Flat Line - Brain Re-Ignition

Updated on January 15, 2015

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.
I do not know whether I could pull the plug on a patient.
I do not know whether I could pull the plug on a patient. | Source

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 Waves

Click thumbnail to view full-size
Alpha Waves are present in rest, in mediation, and in coma.
Alpha Waves are present in rest, in mediation, and in coma.
Alpha Waves are present in rest, in mediation, and in coma. | Source

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) 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
  • FOURscale
  • Simplified Motor Scale

Electricity is Life

Electrical activity in the brain indicates life.
Electrical activity in the brain indicates life. | Source

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?

See results

© 2015 Patty Inglish MS


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    • Patty Inglish, MS profile imageAUTHOR

      Patty Inglish MS 

      3 years ago from USA. Member of Asgardia, the first space nation, since October 2016

      @Barbara Kay - Thanks for your comments and sharing with your friends. Medical treatment will advance to help coma patients more fully now, I am sure.

      I met a man at church who came back to life in the funeral home at the point of embalming and the staff was flabbergasted!

    • Patty Inglish, MS profile imageAUTHOR

      Patty Inglish MS 

      3 years ago from USA. Member of Asgardia, the first space nation, since October 2016

      @Lady Guinevere - I am thankful and happy that your husband recovered from his comatose state in the past and that you have a wonderful life together!

      The program you saw about the woman who came back after living a different life sounds fascinating. I've always felt that there was more to the comatose experience than medical programs have taught us and I think you have given us a good example of that.

      Thanks for sharing and and I think the more people know about this, the more people will have hope if they become comatose.

    • Barbara Kay profile image

      Barbara Badder 

      3 years ago from USA

      This is interesting and would explain people that have afterlife experiences or those that come back to life after being buried. I shared this on Facebook and hope some of my friends read it.

    • Lady Guinevere profile image

      Debra Allen 

      3 years ago from West By God

      This is such a wonderful hub. Many still have no idea how the brain works and grows. My husband, way before I met him, was in a comotose state for three day and then for three months after that he became one of his clients that he was treating. I know his mother and father were going crazy trying to figure things out with him.

      I also watched a program a long time ago and it was about a real person who went into a coma and then when she came out of it she told them of all the things that she was doing while in the coma. She was living another life and could hear the doctors and parents and all those people as if they were in a distance for her to come back. It was fascinating.

      I am sharing this all over!

    • Patty Inglish, MS profile imageAUTHOR

      Patty Inglish MS 

      3 years ago from USA. Member of Asgardia, the first space nation, since October 2016

      The Ohio State University and the Wright State Colleges of Medicine are looking into this currently and when universities and teaching hospitals begin to watch such things, coma patients gain even more hope.

    • Shyron E Shenko profile image

      Shyron E Shenko 

      4 years ago from Texas

      Hello Patty, this is extremely interesting, I am glad to read this.

      Voted up, UABI and sharing.

      I hope all is well with you.

      Blessings and Hugs.

    • Patty Inglish, MS profile imageAUTHOR

      Patty Inglish MS 

      4 years ago from USA. Member of Asgardia, the first space nation, since October 2016

      I look forward to finding additional studies on this topic!

    • tirelesstraveler profile image

      Judy Specht 

      4 years ago from California

      Very interesting. This has been theorized for some time; good it can now be shown.

    • BlossomSB profile image

      Bronwen Scott-Branagan 

      4 years ago from Victoria, Australia

      Such an interesting article. Thank you for sharing this information.

    • mckbirdbks profile image


      4 years ago from Emerald Wells, Just off the crossroads,Texas

      Hello Patty, I am not sure whether to be dustrurbed by this information or impressed. The implications for the past are alarming and the future encouraging.

      You are writing on such a tear.

    • Ericdierker profile image

      Eric Dierker 

      4 years ago from Spring Valley, CA. U.S.A.

      Really really interesting subject matter. I just find it fascinating. I think we have to just look at it as more information when dealing with the decisions that may have to be made. Tough as it may be I would want all information available.

      This should also bring great hope to many.

    • Patty Inglish, MS profile imageAUTHOR

      Patty Inglish MS 

      4 years ago from USA. Member of Asgardia, the first space nation, since October 2016

      @Chris Neal - Its astounding, isn't it? At least the PET scan can help us make a decision. Thanks for reading!

    • Chris Neal profile image

      Chris Neal 

      4 years ago from Fishers, IN

      Wow! That is amazing! And you're right, it does make what is often an already agonizing decision just that much more emotional and difficult. But thank you for the information!


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