Development of EEG activity after ten days of electrocerebral inactivity: ten days of electrocerebral inactivity: a case report in a premature neonate-hydranencephaly or massive ventricular enlargement.

This premature girl demonstrated electrocerebral inactivity in four records over a ten day period. After another eight days with no records, low voltage activity was present at a time when clinical responsiveness increased although the child never developed a prognostically favorable clinical state. The clinical responses never became well developed and the outlook never appeared favorable. If electrocerebral inactivity can be followed by active cortical function in a child who at best had islands of neurons on a deafferented cortex, then some recovery may potentially be possible in the premature child with post bleeding distress and electrocerebral inactivity with apparently present hemisphere tissue. It must be emphasized that "cerebral death" is a syndrome requiring more than electrocerebral inactivity alone. The presently accepted criteria of a single inactive EEG record is not sufficient evidence in itself to predict lack of potential survival in neonates. On the other hand, the return of EEG activity does not predict potential for recovery but only demonstrates a change in CNS function which has to be considered in conjunction with, but not in isolation of, other clinical data to assist the clinician.