Jahi Mcmath: The Most Controversial Ever Known Case Of Suspected Brain Death

14^th Annual Brain Death Congress

November 22-23, 2022 | Webinar

Calixto Machado

Institute of Neurology and Neurosurgery, Havana, Cuba

Scientific Tracks Abstracts: Brain Research

Abstract :

I was a main expert in the case of Jahi McMath, who was diagnosed with brain death (BD). Nonetheless, ancillary tests performed nine months after the initial brain insult showed conservation of intracranial structures, EEG activity, and autonomic reactivity to the “Mother Talks” stimulus. She was clinically unarousable and unresponsive, without evidence of self-awareness or awareness of the environment. However, the total absence of brainstem reflexes and partial responsiveness rejected the possibility of a coma. Jahi did not have unresponsive wakefulness syndrome (UWS) because she was not in a wakefulness state and showed partial responsiveness. She could not be classified as a locked-in syndrome (LIS) patient either because LIS patients are wakeful and aware, and although quadriplegic, they fully or partially preserve brainstem reflexes, vertical eye movements, or blinking, and respire on their own. She was not in a minimally conscious state (MCS because she did not preserve arousal and preserved awareness only partially. The CRS-R resulted in a very low score, incompatible with MCS patients. MCS patients fully or partially preserve brainstem reflexes and usually breathe independently. MCS has always been described as a transitional state between a coma and UWS, but it has never been reported in patients with all clinical BD findings. This case does not contradict the concept of BD but brings the need to use ancillary tests in BD again for discussion. I concluded that Jahi represented a new disorder of consciousness, non-previously described, which I have termed “responsive unawakefulness syndrome” (RUS).

Biography :

Calixto Machado currently works at the Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery, Havana, Cuba. Dr. Machado is a Senior Professor and Researcher in neurology and clinical neurophysiology. Their current projects are “Disorders of consciousness”, “Brain Death”, Autism, ‘Heart Rate Variability in Autonomic Function Assessment in different neurological diseases.