· www.nejm.org · 617 that permit other midbrain reflexes. However, higher concentrations prevent movement and coughing in response to noxious stimuli, effects that might raise the question of brain death. At high concentrations, anesthetic agents can even abolish all midbrain reflexes, including the pupillary light reflex. To the Editor: Wijdicks fails to recognize the deep problems that exist with the concept of brain death. These problems begin with the title of his article, "The Diagnosis of Brain Death." …
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