Coma with Absent Brainstem Reflexes and Burst Suppression after Bupropion Overdose in a Child
Coma associated with absent brainstem reflexes and an initial normal computed tomography (CT) scan is a diagnostic challenge. Spontaneous burst suppression on an electroencephalogram (EEG) may also require explanation. Though unusual, bupropion overdose can present with this constellation of findings. With drug clearance, patients can fully recover. We present a pediatric patient with burst suppression pattern on EEG associated with coma and absent brainstem reflexes following bupropion overdose.
Case Presentation and Management
A 13-year-old girl with history of depression was taken to the local emergency department (ED) after ingesting 21,000 mg of bupropion in an attempt to commit suicide. She was initially conscious but deteriorated shortly after arrival to the ED, when she developed a generalized seizure with subsequent apnea for which she was intubated.
Upon arrival to the pediatric intensive care unit (PICU), her physical examination was significant for a heart rate...
KeywordsBupropion Burst suppression Brain death
- 8.Davoudian V. Bupropion overdose mimicking brain death. American College of Physicians Colorado, Chapter Annual Meeting, 2008. Colorado Springs: Broadmoor Hotel; 2008.Google Scholar