SEPTIC ENCEPHALOPATHY - CLINICAL SYNDROME AND PATHOPHYSIOLOGY

Septic encephalopathy (SE) is present in up to 70% of all patients wit h sepsis. In some cases, SE may preceed other pa ra meters of sepsis. Loss of consciousness to a various extent is the leading symptom. CSF findings and CCT are usually unremarkable. EEG is a sensitive paramete r to monitor SE. EEG-changes deteriorate in correspondence to the degr ee of SE. If sepsis can be treated successfully, clinical and electrop hysiological signs are completely reversible. SE has a complex etiolog y. Bacterial endotoxins and other microbial products trigger the relea se of a multitude of mediators of sepsis. Due to liver dysfunction in sepsis,the brain neurotransmitter profile may be deranged. Other etiol ogical factors include bacteriemia,liver or renal dysfunction,fluid an d electrolyte imbalance, hypoglycemia and drug effects. Due to the pro gnostic significance of early adequate treatment, recognition of SE as a possible initial sign may be crucial for patients with sepsis.