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Updated: May 22, 2026

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Dilated and unreactive pupils and burst-suppression on electroencephalography due to buproprion overdose
Jyoti Pathria Mundi1, Jaime Betancourt, Omar Ezziddin
1Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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.
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