Neurologic Abnormalities in Sepsis

Abstract

Septic shock continues to be a major cause of inhospital mortality (Ziegler et al. 1991). However, improvements in the acute resuscitation of patients presenting with septic shock have changed the nature of this illness. Fewer patients are dying of the early hemodynamic disturbances accompanying bacteremia. Rather, prolonged survival with progressive organ system dysfunction, leading ultimately to death, is the more common clinical course of this patient population (Baue, 1975; Eiseman et al. 1977). Not surprisingly, marked changes in neurologic function are frequently seen in septic patients with organ system dysfunction (Pine et al. 1983). Descriptions of patients with severe neurologic impairment associated with systemic infection date back to the early part of this century (Diamond 1928). However, detailed information on the frequency and different presentations of neurologic abnormalities in septic patients is lacking. This chapter will review the relevant clinical literature regarding neurologic syndromes encountered in human sepsis and examine experimental studies in laboratory animals regarding sepsis-induced alterations in neurophysiology.