Some still consider it to be important to confirm absence of cerebral electrical activity before concluding that a patient is brain dead. Others recommend the use of evoked potentials to assist in the diagnosis since these will be preserved when electroencephalographic silence is attributable to drugs. In the United Kingdom most argue that electroencephalography would only be relevant if the objective was to establish death of the whole brain, not just the brainstem, and that, in any case, an isoelectric electroencephalogram cannot exclude activity in deeper areas of the brain and may have other causes, such as barbiturate coma. Patients have been reported in whom the electroencephalogram was isoelectric but brainstem reflexes were preserved, although this is extremely unusual.

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