nrdsb4 - The "no movemenet" criteria refers to purposeful movement. Totally areflexic - lac of purposeful movement. One of the neurologists at the hospital where I worked would pinch nipples - male or female - to see if this elicited any reflexic movement. (Always made me cringe) If refelxes are present it is a sign that the lower brain - the brain stem - is still functioning, and therefore the patient would not be brain dead. The brain stem functioning but higher brain function being absent is what causes a persistent vegetative state, as opposed to total brain death.