Sepsis-associated Encephalopathy

  • S. Siami
  • A. Polito
  • T. Sharshar


Encephalopathy is a frequent but also a severe neurological manifestation of sepsis. It is clinically characterized by changes in mental status and motor activity ranging from delirium to coma and from agitation to hypoactivity [1]. Agitation and somnolence can occur alternately. Paratonic rigidity, asterixis, tremor, and multifocal myoclonus are other but less frequent motor symptoms. Encephalopathy is associated with altered electroencephalographic (EEG) activity that, depending on severity, ranges from excessive theta to burst suppression [1, 2]. Encephalopathy can be accompanied by elevated plasma levels of, for example, neuron-specific enolase (NSE) and S-100 β-protein [1, 2], which are however not correlated with clinical or EEG severity [1, 2]. Brain magnetic resonance imaging (MRI) can reveal cerebral infarcts or posterior reversible encephalopathy syndrome (PRESS) but also localized to diffuse leukoencephalopathy [3, 4]. It has to be noted that brain MRI may fail to detect some brain lesions observed in neuropathological studies, such as hemorrhages related to disseminated intravascular coagulopathy (DIC), microabscesses or multifocal necrotizing leukoencephalopathy [5].


Cerebral Blood Flow Posterior Reversible Encephalopathy Syndrome Septic Shock Patient Septic Encephalopathy Vanadyl Sulfate 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • S. Siami
    • 1
  • A. Polito
    • 1
  • T. Sharshar
    • 1
  1. 1.General Intensive Care UnitRaymond Poincaré Teaching Hospital (AP-HP)GarchesFrance

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