Decerebrate-like posturing with mechanical ventilation in brain death

Complex spinal cord, spontaneous, or upper limb reflexes are rarely observe d in brain death. The authors describe two brain-dead heart-beating cadaver s (out of 400 consecutive cases in their hospital in the past 9 years) that , immediately after brain-death diagnosis, exhibited sym metric upper limb movements resembling decerebrate posture that were triggered by each mechan ical pulmonary insufflation, and also by superficial pressure and noxious s timuli applied to the arms, thorax, or abdomen. These movements persisted u ntil disconnection from mechanical ventilation.