[Septic encephalopathy]

Septic encephalopathy describes a diffuse cerebral dysfunction in association with sepsis. It is the most common cause of altered brain function in the intensive care unit setting but other causes have to be excluded. Alterations in the level of consciousness occur early and are common. Epileptic seizures may occur but asymmetric neurological findings are not typical. The pathophysiology of septic encephalopathy is diverse and not fully elucidated; however, perfusion abnormalities play an important role. Neuropathological findings are diffuse, widespread and often show features of ischemia and non-bacterial inflammation. Diagnostic procedures should exclude frequent differential diagnoses, such as stroke, meningitis or encephalitis. Cerebral computed tomography (CT) is usually unremarkable but magnetic resonance imaging (MRI) may reveal vasogenic edema in terms of a posterior reversible encephalopathy syndrome. Septic encephalopathy requires an adequate therapy of the sepsis syndrome but a specific therapy is not yet available.