Journal of Neurology

, Volume 253, Issue 7, pp 833–845 | Cite as

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

  • N. W. S. Davies
  • M. K. Sharief
  • R. S. Howard


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 



acute disseminated encephalomyelitis


acute haemorrhagic leukoencephalopathy


acute infectious encephalitis


acute toxic encephalopathy




central nervous system


cerebrospinal fluid


Epstein Barr virus




herpes simplex encephalitis


herpes simplex virus


Japanese encephalitis virus


polymerase chain reaction


peripheral nervous system


periodic lateralised epileptiform discharges


septic encephalopathy


United Kingdom


United States of America


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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