Case Series of Burst Suppression Pattern on Electroencephalography

Introduction: Burst suppression (BS) electroencephalography (EEG) pattern of electrical activity, characterized by intermittent high-power broad-spectrum oscillations alternating with isoelectricity. This pattern has long been observed in the human brain during general anesthesia, hypothermia, coma, hypoxic insult to the brain, and early infantile encephalopathy. This study aims to examine how the characteristics of the BS pattern differ among various etiologies of epilepsy. Case Presentation: We present a case series of patients with history of involuntary movements of the upper and lower limb associated with progressive disability on follow-up. The first patient was of infantile age and had history of delayed milestones. The second patient was middle-aged male with history of refractory status epilepticus and was further evaluated for any hypoxic insult to the brain correlating with clinical history. EEG was done for both the patients and there was characteristic BS pattern on EEG and patients were started on antiepileptics and are under follow-up in the neurology outpatient department. Conclusion: The BS pattern on EEG is an important but often challenging finding, as it can be associated with a wide range of underlying neurological conditions and clinical outcomes. Through this case series, we observed variations in the presentation and characteristics of BS across different etiologies of epilepsy. Careful interpretation of EEG findings in correlation with the clinical picture may help in early diagnosis, prognostication, and guiding further management. Publication History Article published online: 15 July 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Private Limited A-13A, Graphix Tower 1, 6th floor, Sector 62, Noida 201309, Uttar Pradesh, India