REVIEW

Journal of Neurology

, Volume 253, Issue 7, pp 833-845

First online:

Infection–associated encephalopathies—their investigation, diagnosis, and treatment

  • N. W. S. DaviesAffiliated withDepartment of Neurology, Guy’s & St Thomas’Hospitals NHS TrustBatten-Harris Neurological Intensive Care Unit, The National Hospital for Neurology and NeurosurgeryDepartment of Clinical Neurosciences, Hodgkin Building, Guy’s Hospital Email author 
  • , M. K. ShariefAffiliated withDepartment of Neurology, Guy’s & St Thomas’Hospitals NHS TrustDepartment of Clinical Neurosciences, Hodgkin Building, Guy’s Hospital
  • , R. S. HowardAffiliated withDepartment of Neurology, Guy’s & St Thomas’Hospitals NHS TrustBatten-Harris Neurological Intensive Care Unit, The National Hospital for Neurology and Neurosurgery

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Abstract

Reduced level of consciousness is a common clinical finding in acutely sick patients. In the majority of cases a cause for the encephalopathy is readily identifiable,whilst in a minority the aetiology is more difficult to ascertain.

Frequently the onset of encephalopathy is associated with, or follows, infection. The mechanisms through which infection leads to encephalopathy are diverse. They range from direct microbial invasion of the brain or its supporting structures, to remote, infectiontriggered mechanisms such as acute disseminated encephalomyelitis. Most common however, is the encephalopathy caused through a remote effect of systemic sepsis—septic encephalopathy.

This article discusses the clinical presentation and underlying pathogeneses of the acute encephalopathies associated with infection, aiming to aid both their recognition and treatment.

Key words

encephalopathy encephalitis CNS infection neuroimmunology