Leukoencephalopathy associated with extensive burns

Unusual neuropathological changes were observed in two cases following extensive burns. These consisted of perivascular areas of demyelination distributed symmetrically in the brain and affecting the white matter predominantly. One case in addition had widespread petecchial and ring haemorrhages characteristic of brain purpura. Both patients sustained second and third degree burns in greater than 50% of the body surface area, developed metabolic acidosis, sepsis, disturbance in consciousness and multiple episodes of cardiorespiratory arrest prior to death. A toxic metabolic state related to a burn toxin released from the damaged tissue or from bacterial action to the tissue in addition to low platelet level is proposed as the major pathogenetic factor in the development of the neurological symptoms and the patients' demise.