<p>Brain death is defined as the complete and <strong>permanent</strong> loss of brain function (1), or complete, <strong>irreversible</strong> cessation of brain function (2), or <strong>irreversible</strong> cessation of all functions of the whole brain (3). Therefore, according to these definitions, once brain death occurs, it cannot be reversed, and even if one tries to treat this condition by any treatment or intervention (including the suggested brain defibrillation), it will not be successful.</p>
<p>However, it is very important to note that <strong>not all</strong> patients who have loss all functions of the whole brain and appear to be in deep coma have brain death. Some of them have <strong>reversible</strong> causes, such as overdosage of CNS (central nervous system) depressant drugs, severe hypothermia, and severe metabolic (acid-base, electrolyte, endocrine, etc.) abnormalities. (1-3). These patients can be revived and their coma can be reveresed not by some kind of brain defibrillation but by treating the cause. Even in patients who are in coma from non-convulsive status epilepticus and have generalized abnormal electrical discharges in their brains (as can be diagnosed from EEG – electroencephalogram), which may be considered the brain equivalence of the heart fibrillation, the treatment is intravenous antiepileptic drug injection, not any kind of brain defibrillation, to stop the abnormal cerebral discharges. (4)</p>
<p>Thus, one of the utmost important points in diagnosing brain death is to establish that the condition of the patient is <strong>irreversible and permanent</strong>. This can be done by establishing the cause to be an irreversible, destructive, structural disease or condition, such as prolonged cardio-pulmonary arrest, or a large intracerebral hemorrhage or a massive cerebral contusion, both with severe brain edema and herniation compressing the brainstem; and by ruling out reversible causes (mentioned above).</p>
<p>Yet, it is <em>not that no kind of electrical shock to brain has some role in medical treatment</em>. Regarding the idea of brain defibrillation, there is indeed a medical intervention that delivers an electrical shock to the brain; the procedure is called electroconvulsive therapy or electroshock therapy. (5,6) But it is not done to revive near-brain-death or other comatose patients but to treat some psychiatric disorders, such as depression, bipolar disorder, and schizophrenia.</p>
<p><strong>References.</strong></p>
<ol>
<li><p>David M. Greer, MD, MA1; Sam D. Shemie, MD2,3; Ariane Lewis, MD4; et al. <a href="https://jamanetwork.com/journals/jama/fullarticle/2769149" rel="nofollow noreferrer">Determination of Brain Death/Death by Neurologic Criteria. The World Brain Death Project.</a> JAMA. 2020;324(11):1078-1097. doi:10.1001/jama.2020.11586</p>
</li>
<li><p>G Bryan Young. <a href="https://www.uptodate.com/contents/diagnosis-of-brain-death?search=brain%20death&amp;source=search_result&amp;selectedTitle=1%7E150&amp;usage_type=default&amp;display_rank=1" rel="nofollow noreferrer">Diagnosis of brain death</a> In. Janet L Wilterdink, editor. UpToDate. Sep 02, 2020</p>
</li>
<li><p>American Academy of Neurology (AAN) guideline. <a href="https://www.aan.com/Guidelines/home/GetGuidelineContent/432" rel="nofollow noreferrer">Update: Determining Brain Death in Adults</a></p>
</li>
<li><p>Raoul Sutter, Stephan Rüegg, Peter W. Kaplan. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829470/" rel="nofollow noreferrer">Epidemiology, diagnosis, and management of nonconvulsive status epilepticus</a> Neurol Clin Pract. 2012 Dec; 2(4): 275–286.</p>
</li>
<li><p>Charles Kellner. <a href="https://www.uptodate.com/contents/overview-of-electroconvulsive-therapy-ect-for-adults?search=electroconvulsive%20therapy&amp;sectionRank=1&amp;usage_type=default&amp;anchor=H30&amp;source=machineLearning&amp;selectedTitle=1%7E133&amp;display_rank=1#H30" rel="nofollow noreferrer">Overview of electroconvulsive therapy (ECT) for adults.</a> In: David Solomon, editor. UpToDate. Dec 01, 2020.</p>
</li>
<li><p>Wikipedia. <a href="https://en.wikipedia.org/wiki/Electroconvulsive_therapy" rel="nofollow noreferrer">Electroconvulsive therapy</a></p>
</li>
</ol>

CC BY-SA 4.0
2020-12-06T10:36:30.333Z
2020-12-06T10:56:06.960Z
2020-12-06T10:56:06.960Z
user287279
<p>Is the analogy of a defribillator for a brain be able to tackle brain deaths ? What are the limitations to this idea?</p>

<brain-waves><experimental-neuroscience>
Can a brain dead person be revived through a modified defribillator?
Parvathy
# Can a brain dead person be revived through a modified defribillator?

(Asked by: username_0 on 2020-12-06)

Is the analogy of a defribillator for a brain be able to tackle brain deaths ? What are the limitations to this idea?

**Tags:** brain-waves, experimental-neuroscience


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## 1 answers

### Answer by username_1 on 2020-12-06. Score: 3

Brain death is defined as the complete and **permanent** loss of brain function (1), or complete, **irreversible** cessation of brain function (2), or **irreversible** cessation of all functions of the whole brain (3). Therefore, according to these definitions, once brain death occurs, it cannot be reversed, and even if one tries to treat this condition by any treatment or intervention (including the suggested brain defibrillation), it will not be successful.

However, it is very important to note that **not all** patients who have loss all functions of the whole brain and appear to be in deep coma have brain death. Some of them have **reversible** causes, such as overdosage of CNS (central nervous system) depressant drugs, severe hypothermia, and severe metabolic (acid-base, electrolyte, endocrine, etc.) abnormalities. (1-3). These patients can be revived and their coma can be reveresed not by some kind of brain defibrillation but by treating the cause. Even in patients who are in coma from non-convulsive status epilepticus and have generalized abnormal electrical discharges in their brains (as can be diagnosed from EEG – electroencephalogram), which may be considered the brain equivalence of the heart fibrillation, the treatment is intravenous antiepileptic drug injection, not any kind of brain defibrillation, to stop the abnormal cerebral discharges. (4)

Thus, one of the utmost important points in diagnosing brain death is to establish that the condition of the patient is **irreversible and permanent**. This can be done by establishing the cause to be an irreversible, destructive, structural disease or condition, such as prolonged cardio-pulmonary arrest, or a large intracerebral hemorrhage or a massive cerebral contusion, both with severe brain edema and herniation compressing the brainstem; and by ruling out reversible causes (mentioned above).

Yet, it is *not that no kind of electrical shock to brain has some role in medical treatment*. Regarding the idea of brain defibrillation, there is indeed a medical intervention that delivers an electrical shock to the brain; the procedure is called electroconvulsive therapy or electroshock therapy. (5,6) But it is not done to revive near-brain-death or other comatose patients but to treat some psychiatric disorders, such as depression, bipolar disorder, and schizophrenia.

**References.**

1. David M. Greer, MD, MA1; Sam D. Shemie, MD2,3; Ariane Lewis, MD4; et al. [Determination of Brain Death/Death by Neurologic Criteria. The World Brain Death Project.](https://jamanetwork.com/journals/jama/fullarticle/2769149) JAMA. 2020;324(11):1078-1097. doi:10.1001/jama.2020.11586
2. G Bryan Young. [Diagnosis of brain death](https://www.uptodate.com/contents/diagnosis-of-brain-death?search=brain%20death&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1) In. Janet L Wilterdink, editor. UpToDate. Sep 02, 2020
3. American Academy of Neurology (AAN) guideline. [Update: Determining Brain Death in Adults](https://www.aan.com/Guidelines/home/GetGuidelineContent/432)
4. Raoul Sutter, Stephan Rüegg, Peter W. Kaplan. [Epidemiology, diagnosis, and management of nonconvulsive status epilepticus](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829470/) Neurol Clin Pract. 2012 Dec; 2(4): 275–286.
5. Charles Kellner. [Overview of electroconvulsive therapy (ECT) for adults.](https://www.uptodate.com/contents/overview-of-electroconvulsive-therapy-ect-for-adults?search=electroconvulsive%20therapy§ionRank=1&usage_type=default&anchor=H30&source=machineLearning&selectedTitle=1%7E133&display_rank=1#H30) In: David Solomon, editor. UpToDate. Dec 01, 2020.
6. Wikipedia. [Electroconvulsive therapy](https://en.wikipedia.org/wiki/Electroconvulsive_therapy)


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