P31-T Burst-suppression pattern is not always predicting poor prognosis in children

Among the numerous pathological changes of the EEG in critical conditions burst-suppression pattern (BSP) is considered to be most ominous and indicating the poor prognosis. BSP is diagnosed when 50% of all EEG is replaced by the isoelectric flatline, interchanged with normal amplitude bursts. BSP is best studied in adults; in pediatric critical care its less explored. We have seen the clinical case of the 5-years old girl with critical condition due to viral encephalitis who had typical BSP for 7 days; no general anesthetics were used during this time; afterwards her condition significantly improved, consciousness restored. BSP accordingly disappeared from her EEG. Thus, BSP in pediatric population indicates severe disruption of the bioelectric activity of the brain. In some pediatric cases although, this pattern is not indicating inevitable poor prognosis and clinical condition may be improved after the proper intensive care is applied. Also this clinical case demonstrates the necessity to perform EEG as often as possible in children with critical illness; also we are stressing out the clinical usefulness in these cases of the somatosensory evoked potentials (SSEPs), which are independent of drug profile of intensive care and were proved decisive as a prognostic tool in these conditions.