Certain Sepsis Complications Often Go Overlooked

According to a new study, complications of sepsis such as delirium and muscle weakness frequently go unnoticed and are inadequately understood. 

Authors from Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine find that “some of the least understood effects” of sepsis are the associated neurologic complications, such as seizures, strokes, delirium, neuromuscular disorders, and encephalopathy, or brain disease. Delirium, the researchers say, can be either hyperactive (agitation and hallucinations, for example) or hypoactive, which is marked by sluggishness, drowsiness, and inattention.
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The peripheral nervous system, the authors write, has gained the most consideration and thought, largely due to dependence on mechanical ventilation. The aforementioned central nervous system complications related to sepsis, however, “have only more recently gained attention, but continue to go unnoticed,” according to the researchers, who note that, aside from the clinical examination, electroencephalography is a sensitive tool for prognostication or uncovering non-convulsive seizures in encephalopathic patients. The investigators add that there is no specific treatment for sepsis-associated encephalopathy (SAE), and recommend that physicians focus on treating the underlying infectious disease process.

Jorge Ortiz, MD, a neurology resident at Loyola University Medical Center and co-author of the study, urges primary care practitioners to “be aware that sepsis is a dynamic process involving a systemic inflammatory response to a suspected or known infection, which can manifest with a wide variety of respiratory, cardiac, renal, endocrine, and hepatic signs and symptoms.”

Neurologic complications “are not the exception, as sepsis-associated encephalopathy, seizures, cerebrovascular events, and neuromuscular disorders can cause permanent deficits directly related to the infectious process,” says Ortiz. “Early detection of sepsis is crucial, followed by initiation of aggressive treatment in order to prevent peripheral or central nervous system complications.”

—Mark McGraw

Reference

Sweis R, Ortiz J, et al. Neurology of Sepsis. Current Neurology and Neuroscience Reports. 2016.