Background Reflex and spontaneous movements are not uncommon in brain death patients. However, most studies have been conducted in adults, while reports in infants and children are rare. Thus, we aimed to evaluate the frequency and characteristics of these movements in pediatric patients declared as brain death.

Methods Records of pediatric patients who were diagnosed as brain death from 15 hospitals in the Yeongnam region, South Korea, between January 2013 and September 2016 were analyzed. All body movements in patients who met the criteria for brain death as established by the Korea Medical Association were assessed by medical doctors and trained organ transplant coordinators. The frequency and characteristics of these movements were identified. Additionally, the demographic and clinical factors of the brain death patients with and without these movements were compared.

Results A total of 31 patients who met the criteria for brain death were enrolled. Seven patients (22.6%) showed either reflex or spontaneous movements; six of them (85.7%) showed reflex movements only, and one patient (14.3%) showed both types of movements. The most common types of reflex movements were the flexor/extensor plantar response and isolated finger jerk. Four of seven patients (57.1%) showed a single movement pattern, while three (42.9%) showed two different movement patterns.

Conclusion It is essential for physicians who perform pediatric brain death examinations to recognize the frequency and characteristics of reflex and spontaneous movements, and this article may help in the accurate and prompt diagnosis of brain death.

背景 反射和自发运动在脑死亡患者中并不少见。然而，大多数研究都是在成人中进行的，而在婴儿和儿童中的报道很少。因此，我们旨在评估这些运动在被宣布为脑死亡的儿科患者中的频率和特征。

方法 对 2013 年 1 月至 2016 年 9 月韩国永南地区 15 家医院被诊断为脑死亡的儿科患者的记录进行分析。符合韩国医学会制定的脑死亡标准的患者的所有身体运动均由医生和经过培训的器官移植协调员进行评估。确定了这些运动的频率和特征。此外，比较了有和没有这些运动的脑死亡患者的人口统计学和临床​​因素。

结果 共纳入符合脑死亡标准的患者31例。七名患者（22.6%）表现出反射性或自发性运动；其中 6 人 (85.7%) 仅表现出反射运动，1 名患者 (14.3%) 表现出两种类型的运动。最常见的反射运动类型是屈肌/伸肌足底反应和孤立的手指抽搐。七名患者中有四名（57.1%）表现出单一的运动模式，而三名（42.9%）表现出两种不同的运动模式。

结论 进行小儿脑死亡检查的医师了解反射性和自发性运动的频率和特征是必不可少的，本文可能有助于准确、及时地诊断脑死亡。