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The Encephalopathy of Sepsis

Published online by Cambridge University Press:  18 September 2015

Alan C. Jackson ,
Joseph J. Gilbert ,
G. Bryan Young  and
Charles F. Bolton
Alan C. Jackson
Affiliation:
Departments of Clinical Neurological Sciences and Pathology, Victoria Hospital and The University of Western Ontario, London, Ontario
Joseph J. Gilbert
Affiliation:
Departments of Clinical Neurological Sciences and Pathology, Victoria Hospital and The University of Western Ontario, London, Ontario
G. Bryan Young
Affiliation:
Departments of Clinical Neurological Sciences and Pathology, Victoria Hospital and The University of Western Ontario, London, Ontario
Charles F. Bolton*
Affiliation:
Departments of Clinical Neurological Sciences and Pathology, Victoria Hospital and The University of Western Ontario, London, Ontario
*
Department of Clinical Neurological Sciences, Victoria Hospital, London, Ontario, Canada N6A 4G5
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Abstract:

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Twelve fatal cases of encephalopathy associated with sepsis were examined in a ten-year retrospective study. The sources of infection and organisms isolated were variable. Six of the patients had focal neurologic signs; five had seizures. The level of consciousness varied from drowsiness to deep coma, and electroencephalograms revealed diffuse or multifocal abnormalities. Computed tomographic head scans and cerebrospinal fluid examinations were usually unremarkable. Eight patients had disseminated microabscesses in the brain at autopsy. Four patients had proliferation of astrocytes and microglia in the cerebral cortex, a feature associated with metabolic encephalopathies. Additional findings included cerebral infarcts, brain purpura, multiple small white matter hemorrhages, and central pontine myelinolysis. Although sepsis may cause encephalopathy by producing disturbances in cerebral synaptic transmission and cerebral energy production through a toxic mechanism, bacterial invasion of the brain with the formation of disseminated microabscesses is also an important cause.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 12 , Issue 4 , November 1985 , pp. 303 - 307
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

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