Sepsis associated encephalopathy

SummaryA diffuse cerebral dysfunction is often present in sepsis and may ensue even before signs of other organ failure. This condition is better defined as “sepsis associated encephalopathy” (SAE), in order to stress the absence of direct infection of the central nervous system (CNS). The main sign of SAE is an altered mental status. Electroencephalography is the more sensitive diagnostic test, and allows the staging of the severity of cerebral dysfunction that is related to outcome. SAE is potentially reversible, but it always worsens the prognosis. The pathophysiology of SAE is not still completely understood, and it is probably multifactorial. Indeed, brain dysfunction in sepsis may be related to the action of microorganisms toxins, to the effects of inflammatory mediators, to metabolic alterations and to abnormalities in cerebral circulation. Up to date, a specific treatment for SAE does not exist and outcome relies upon prompt and appropriate treatment of sepsis and septic shock.