The Encephalopathy Associated with Septic Illness: Clinical Neurological Features

Summary

Septic encephalopathy resembles many metabolic encephalopathies and is largely reversible, although some survivors of severe septic illness may have residual cognitive problems. These deficits may relate to microscopic abnormalities in the brain that we have found at autopsy. Biochemical abnormalities are directly related to the severity of the encephalopathy. It is unlikely that organ failure accounts for the early encephalopathy, but multi-organ failure probably contributes to brain dysfunction in advanced sepsis.

Electroencephalographic (EEG) changes run parallel to the clinical severity of the brain dysfunction, biochemical derangements and the failure of other organ systems. Each of these stages is potentially reversible, although mortality rises proportionally with the severity of the EEG abnormality. Deaths are usually due to multi-organ, rather than brain, failure.