Occurrence of nervous system involvement in SIRS

Area of Science:

• Neurology
• Critical Care Medicine
• Internal Medicine

Background:

• Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory condition impacting organ systems, including the nervous system.
• Neurological complications can significantly affect patient outcomes in critical care settings.

Purpose of the Study:

• To describe the spectrum of neurological and neuromuscular disorders in patients with SIRS.
• To characterize the prevalence and types of central and peripheral nervous system involvement in a cohort of SIRS patients.

Main Methods:

• Retrospective analysis of 64 patients diagnosed with SIRS.
• Clinical neurological examination, neuroimaging (MRI), cerebrospinal fluid analysis, electroencephalography (EEG), and electrophysiological studies were performed.
• Nerve and muscle biopsies were conducted in select cases.

Main Results:

• Central nervous system involvement was observed in 56.3% of patients, primarily presenting as encephalopathy (75%), seizures (13.9%), and ischemic stroke (8.3%).
• Neuromuscular disorders affected 43.7% of patients, with critical illness polyneuropathy (57.1%) and critical illness myopathy (32.1%) being most prevalent.
• Encephalopathic patients showed unremarkable findings on MRI, CSF, and EEG; nerve and muscle pathology studies ruled out inflammatory abnormalities.

Conclusions:

• Neurological and neuromuscular complications are frequent in SIRS patients.
• Encephalopathy and critical illness polyneuropathy are significant manifestations requiring further investigation into their underlying mechanisms.
• Early identification of these neurological conditions is crucial for improving patient prognosis and managing healthcare costs.