was maintained in all patients; transient lateral rectus weakness was noticed in one patient that recovered in 2 weeks.
The determination of brain death should fulfill the absence of all the above five brainstem reflexes (pupillary light reflex, corneal reflex
, oculocephalogyric reflex, oculovestibular reflex, and cough reflex).
Clinical signs like temperature, pulse, heart rate, blood pressure, coma severity by MGCS Score, respiratory pattern, pupillary reflex, corneal reflex
, extraocular movements, motor pattern, and fundal picture were studied.
For an esotropia and exotropia deviation, the corneal reflex
in the deviated eye appears displaced temporally and nasally, respectively.
The absence of pupillary reflex was noted in 71 (93.4%), absence of response to painful stimulus/coma in 70 (92%), absence of spontaneous breathing in 66 (86.8%), absence of corneal reflex
in 63 (82.9%), absence of cough reflex in 63 (81.6%), absence of gag reflex in 62 (81.6%), absence of oculovestibular reflex in 59 (77.6%), and absence of oculocephalic reflex in 59 (77.6%; Figure 2).
In the reliability test, the manikin was maneuvered by a trained operator according to a protocol of responses for each patient case in terms of breathing pattern, respiratory rate, blinking in the testing of corneal reflex
, and coughing during the suction of airways.
Menace reflex, corneal reflex
, pupillary light reflex were absent, but palpebral reflex was present in affected eye in both cases.
"There is now data to suggest that most of these reflexes, though not the corneal reflex
, are present in the newborn baby at term - 37 completed weeks gestation or more - though they are not in premature babies born earlier than this gestation."
The initial Glasgow score, the presence of unilateral or bilateral dilated pupils, the presence of a corneal reflex
in the case of bilateral dilated pupils, and the various treatments administered before craniectomy, such as mannitol or barbiturates, were recorded.