Journal of Neurology

, Volume 253, Issue 7, pp 833–845

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

REVIEW

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 

Abbreviations

ADEM

acute disseminated encephalomyelitis

AHLE

acute haemorrhagic leukoencephalopathy

AIE

acute infectious encephalitis

ATE

acute toxic encephalopathy

CMV

cytomegalovirus

CNS

central nervous system

CSF

cerebrospinal fluid

EBV

Epstein Barr virus

EEG

electroencephalogram

HSE

herpes simplex encephalitis

HSV

herpes simplex virus

JEV

Japanese encephalitis virus

PCR

polymerase chain reaction

PNS

peripheral nervous system

PLEDS

periodic lateralised epileptiform discharges

SE

septic encephalopathy

UK

United Kingdom

USA

United States of America

WNV

West Nile Virus

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Copyright information

© Steinkopff-Verlag 2006

Authors and Affiliations

  • N. W. S. Davies
    • 1
    • 2
    • 3
  • M. K. Sharief
    • 1
    • 3
  • R. S. Howard
    • 1
    • 2
  1. 1.Department of NeurologyGuy’s & St Thomas’Hospitals NHS TrustLondonUK
  2. 2.Batten-Harris Neurological Intensive Care UnitThe National Hospital for Neurology and NeurosurgeryLondonUK
  3. 3.Department of Clinical NeurosciencesHodgkin Building, Guy’s HospitalLondon, SE1 1 ULUK

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