Decerebrate-like posturing with mechanical ventilation in brain death

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