Septic encephalopathy

Abstract

Encephalopathy refers to a syndrome of global brain dysfunction. Septic encephalopathy shows a devastating neurological symptom. Here we introduce the septic encephalopathy, encephalopathy associated with sepsis. The pathogenesis of septic encephalopathy originates from the following order: (1) infection, (2) systemic inflammatory response syndrome (a whole-body inflammatory state), (3) multiple-organ dysfunction. These processes finally lead to be the symptoms of septic encephalopathy including mental confusion and delirium. The sequelas provoke the social issue. Accumulating body of studies suggest the hypothetical molecular mechanisms for pathophysiology of septic encephalopathy. The sensing of pathogen-associated molecular patterns such as lipopolysaccharides and peptidoglycans, and damage-associated molecular patterns such as endogenous DNAs and high mobility group box (HMGB)-1 by pattern recognition receptors drives a coordinated immune response. Sepsis is accompanied by a remarkable altered and imbalanced cytokine response (known as a cytokine storm), which burdens onto organs and results in multiple-organ dysfunctions. These processes finally result in septic encephalopathy. On the other hand, brain hemorrhage, edema, and ischemia were also found as complicated symptoms associated with sepsis. Hence, septic encephalopathy includes not only inflammatory symptoms but also neurovascular diseases. These neurovascular involvements may render the septic encephalopathy to be complicated diseases. Conversely, several kinds of trials have been tackled to control the immunological response in sepsis without successful. Recently, however, several lines of evidence suggest the validity that electrical stimulation of vagus nerve on the cervix after onset of sepsis may regulate the over-expressing cytokines and result in better prognosis. Hence, in this chapter, septic encephalopathy is discussed from molecular mechanisms to future therapeutic potential for the patho-physiology, respectively, in the following section: (1) causes, (2) symptoms, (3) potential complications in the future studies. © 2013 by Nova Science Publishers, Inc. All rights reserved.