Lazarus syndrome and Lazarus reflex are phenomena that can be associated with horror movies, but in practice their occurrence - although rare - is possible in our real world. Lazarus syndrome is the return of circulation in people who have previously stopped circulating, while the Lazarus reflex is an unusual motor reaction in people with brain death. Only a few dozen cases of Lazarus syndrome have been described worldwide. What are their causes?

Lazarus syndrome(Eng.Lazarus phenomenon ) was first observed in 1982, and the phenomenon was named with this term only in 1993 - such a name was proposed by J.G. Bray.

Fewer than40 episodes of Lazarus syndrome have been described so far , but there are assumptions that some cases of this problem are not recognized and in fact the incidence of this syndrome is actually slightly higher .

Lazarus syndrome: what is it about?

The definition of the problem did not come out of nowhere - it is called the Lazarus syndrome due to the fact that in his case - like the biblical Lazarus thanks to Jesus - people who were considered dead come back to the living.

Lazarus syndrome is mainly observed in people who have undergone CPR, which was ultimately considered unsuccessful. Sometimes, however, in such situations it turned out that the patient did not die at all - after some time his circulatory system resumed work and the patient's condition was finally stabilized.

As mentioned above, Lazarus syndrome is a veryrare entitya - after all, almost four decades have passed since it was first described, and so far it has been observed in very few people.

Cases of this problem usually attract a lot of attention - but it is not difficult to be surprised by the media hype when the patient essentially "rises". Interestingly, the phenomenon has so far been recorded in countries distant from our country, but it also occurred in one Polish woman.

Lazarus syndrome: case reports

In Poland, you could hear about Lazar's syndrome mainly in 2014. It was then that91-year-old womana, a resident of the Lublin Province, was declared dead by medics.

It is therefore not hard to wonder that she was transported tohence to the hospital morgue. The surprise was certainly, however, that after several hours … the woman woke up.

  • She survived her own death! Mrs. Janina was Risen in the morgue!

Another described case of Lazarus syndrome took place in the United States. It featured on78-year-old manand also happened in 2014.

One February evening the man was pronounced dead by the coroner due to lack of circulation.

This situation is probably remembered by the workers of the funeral home where this man was sent to this day - after some time after the potentially deceased man was transported to this place, it turned out that the patient was alive and was able to move around.

Looking at the stories described above, you might think that Lazarus syndrome is only found in older people - but it is not.

The story of a 27-year-old Briton who lost consciousness after an overdose of heroin and cocaine was also described. Medical assistance arrived at the scene, whose actions initially proved effective, thanks to the administration of drugs, the man was able to go to the ambulance on his own. However, there were some complications on the way to the hospital: the patient was in cardiac arrest. The 25-minute resuscitation was apparently unsuccessful, so the resuscitation was terminated and the patient was presumed dead. After a minute, however, the medics changed their mind: the patient's heart rhythm was restored on the monitoring equipment, and resuscitation was resumed. Eventually, the man completely recovered.

Lazarus syndrome: causes of occurrence

Lazarus syndrome can certainly be considered one of the most interesting medical problems.

Medics have already managed to gain some knowledge about it - they noticed, for example, that in80% of casesof this unit, the return to circulation takes place within10 minutesfrom his detention. Another observation was that almost half of the patients who experienced Lazarus syndrome had no neurological loss .

However, the greatest attention of scholars is drawn to the possible causes of Lazarus syndrome: here, however, some information is simply missing.

One theory of where Lazarus syndrome comes from focuses on the phenomena associated with CPR. Well, during it, the chest is subjected to pressure.

When CPR is interrupted, the pressure will gradually drop and the chest will relax. This, in turn, is a phenomenonmay cause the heart muscle to relax, which would lead to stimulation of the cardiac conduction system.

This creature is a kind of pacemaker of our heart and its stimulation, taking place in the above-described situation, could potentially lead to the return of circulation in a person who is presumed dead.

But there are also other theories about the pathogenesis of Lazarus syndrome. One of them focuses on medications that are used during resuscitation. It is possible that, when the patient is not circulating blood, the drugs are not actually being distributed properly in the body. After some time, however, with a delay, they can finally reach the structures on which they are to affect (primarily the heart muscle) and only then exert the expected actions, resulting in the Lazarus syndrome.

Another possible causative factor of Lazarus syndrome is hyperkalemia, i.e. an increased level of potassium in the blood - however, in which mechanism potassium would lead to the described problem, it is not fully known.

Lazarus syndrome, or why deaths need to be decided very carefully

People are afraid of death, but the vision of waking up after a dozen or so hours in the morgue or only in the grave is probably even more terrifying. These fears can be dispelled though - Lazarus syndrome is truly an extremely rare entity.

Theoretically, it could be concluded that if the patient returns to the living after some time, the doctors who pronounced him dead made a mistake. However, it is difficult to talk about a mistake here - in the case of Lazarus syndrome, it is true that a person has a cardiac arrest for some time, which basically allows for a declaration of death.

This problem - although rarely - may occur, therefore there are recommendations that the patient should be monitored for some time after a failed resuscitation.

It is impossible to say how long such an observation should last - after all, patients with Lazarus syndrome can come back alive both within minutes and hours.

Overall, however, as already noted above, in the vast majority of cases, recovery of cardiovascular function occurs within 10 minutes of its arrest, therefore, for at least this time, a person who is considered deceased should be monitored in order to detect possible signs of life.

Lazarus reflex: what is it?

The theoretically related problem, but actually different from the Lazarus syndrome, isLazarus reflex .

Certainly Lazarus' reflex can be astonishingmedical staff, and - completely wrongly - convince relatives of a person with brain death that they did not really die at all.

Lazarus' reflex consists in the fact that an unconscious person suddenlyraises his upper limbsand then crosses them on his chest - eventually he takes a pose similar to those you observe you can uEgyptian mummies .

The Lazarus reflex is encountered, as mentioned above, in patients with brain death. It is not hardly surprising that it may give rise to hopes that the state traditionally considered fatal is not so.

The occurrence of the Lazarus reflex, unfortunately, is not a phenomenon that would suggest that the patient's nervous system activity may still return. The phenomenon is compared to other unconditional reflexes, such asknee reflex .

The Lazarus reflex occurs through the reflex arc - the spinal cord, not the brain, is involved in this movement, and therefore in people who have died of the brain, it may occur in the presence of spinal cord function.

This problem may be preceded by e.g. disconnecting the patient from the breathing apparatus.

Category:

Neurology