title: Dilated and unreactive pupils and burst-suppression on electroencephalography due to buproprion overdose.
abstract: Burst-suppression pattern on electroencephalography (EEG) occurs upon dissociation of the cortex from underlying brain structures. Unless the pattern is a physiologic consequence of administered sedatives, this electroencephalographic pattern is indicative of a poor neurologic outcome and high mortality. We report a case of a 29-year-old female thought to be brain dead based on initial physical examination and EEG findings of burst-suppression, who was later found to have supratherapeutic serum levels of bupropion. This is the second documented case of burst-suppression pattern on EEG in a patient who overdosed on bupropion. We propose that burst-suppression in the setting of bupropion toxicity may revert with drug clearance.
authors.affiliation: Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Jyoti Pathria
authors.initials: JP
authors.lastname: Mundi
authors.forename: Jaime
authors.initials: J
authors.lastname: Betancourt
authors.forename: Omar
authors.initials: O
authors.lastname: Ezziddin
authors.forename: Brandie
authors.initials: B
authors.lastname: Tremayne
authors.forename: Tamara
authors.initials: T
authors.lastname: Majic
authors.forename: Zab
authors.initials: Z
authors.lastname: Mosenifar
mesh_terms: D000328:Adult; D016642:Bupropion / Q000506:poisoning*; D062787:Drug Overdose / Q000150:complications* / Q000628:therapy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D009424:Nervous System Physiological Phenomena / Q000187:drug effects; D011681:Pupil Disorders / Q000139:chemically induced* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D016642:Bupropion