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Related to brain stem reflexes: Oculocephalic reflex
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Recent guidelines state that absence of all brain stem reflexes should be documented [5].
Neurotoxic envenomation presents as a broad spectrum starting from ptosis and ophthalmoplegia to respiratory arrest and loss of brain stem reflexes mimicking brain death, thus prompting clinical staff to consider withdrawing ventilator support, which is harmful.
In both the cases, brain stem reflexes did not return and both patient died eventually.
They described 23 comatose patients who had lost all brain stem reflexes and shown a flat electroencephalogram (EEG; Greer, Varelas, Haque, & Wijdicks, 2008).