Reversible Burst-suppression Pattern of Acute Hyperammonemic Encephalopathy

Acute hyperammonemic encephalopathy is generally associated with severe liver disease, manifesting with neuropsychiatric symptoms including confusion, lethargy, seizure, coma, and even death. Electroencephalogram (EEG) is a proven diagnostic, prognostic, and therapeutic tool in patients with acute and chronic encephalopathies. EEG changes in acute hyperammonemic encephalopathy are associated with background slowing in theta to delta ranges, accompanied by presence of triphasic waves. We reported a patient with acute hyperammonemic encephalopathy showing an unusual burst-suppression pattern, which was reversible with proper treatment.