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Seizures and Sepsis: A Narrative Review
Patients with sepsis-associated encephalopathy (SAE) can develop convulsive or nonconvulsive seizures. The cytokine storm and the overwhelming systemic inflammation trigger the electric circuits that promote seizures. Several neurologic symptoms, associated with this disease, range from mild conscio...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959335/ https://www.ncbi.nlm.nih.gov/pubmed/33802419 http://dx.doi.org/10.3390/jcm10051041 |
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author | Alessandri, Francesco Badenes, Rafael Bilotta, Federico |
author_facet | Alessandri, Francesco Badenes, Rafael Bilotta, Federico |
author_sort | Alessandri, Francesco |
collection | PubMed |
description | Patients with sepsis-associated encephalopathy (SAE) can develop convulsive or nonconvulsive seizures. The cytokine storm and the overwhelming systemic inflammation trigger the electric circuits that promote seizures. Several neurologic symptoms, associated with this disease, range from mild consciousness impairment to coma. Focal or generalized convulsive seizures are frequent in sepsis, although nonconvulsive seizures (NCS) are often misdiagnosed and prevalent in SAE. In order to map the trigger zone in all patients that present focal or generalized seizures and also to detect NCS, EEG is indicated but continuous EEG (cEEG) is not very widespread; timing, duration, and efficacy of this tool are still unknown. The long-term risk of seizures in survivors is increased. The typical stepwise approach of seizures management begins with benzodiazepines and follows with anticonvulsants up to anesthetic drugs such as propofol or thiopental, which are able to induce burst suppression and interrupt the pathological electrical circuits. This narrative review discusses pathophysiology, clinical presentation, diagnosis and treatment of seizures in sepsis. |
format | Online Article Text |
id | pubmed-7959335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79593352021-03-16 Seizures and Sepsis: A Narrative Review Alessandri, Francesco Badenes, Rafael Bilotta, Federico J Clin Med Review Patients with sepsis-associated encephalopathy (SAE) can develop convulsive or nonconvulsive seizures. The cytokine storm and the overwhelming systemic inflammation trigger the electric circuits that promote seizures. Several neurologic symptoms, associated with this disease, range from mild consciousness impairment to coma. Focal or generalized convulsive seizures are frequent in sepsis, although nonconvulsive seizures (NCS) are often misdiagnosed and prevalent in SAE. In order to map the trigger zone in all patients that present focal or generalized seizures and also to detect NCS, EEG is indicated but continuous EEG (cEEG) is not very widespread; timing, duration, and efficacy of this tool are still unknown. The long-term risk of seizures in survivors is increased. The typical stepwise approach of seizures management begins with benzodiazepines and follows with anticonvulsants up to anesthetic drugs such as propofol or thiopental, which are able to induce burst suppression and interrupt the pathological electrical circuits. This narrative review discusses pathophysiology, clinical presentation, diagnosis and treatment of seizures in sepsis. MDPI 2021-03-03 /pmc/articles/PMC7959335/ /pubmed/33802419 http://dx.doi.org/10.3390/jcm10051041 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Alessandri, Francesco Badenes, Rafael Bilotta, Federico Seizures and Sepsis: A Narrative Review |
title | Seizures and Sepsis: A Narrative Review |
title_full | Seizures and Sepsis: A Narrative Review |
title_fullStr | Seizures and Sepsis: A Narrative Review |
title_full_unstemmed | Seizures and Sepsis: A Narrative Review |
title_short | Seizures and Sepsis: A Narrative Review |
title_sort | seizures and sepsis: a narrative review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959335/ https://www.ncbi.nlm.nih.gov/pubmed/33802419 http://dx.doi.org/10.3390/jcm10051041 |
work_keys_str_mv | AT alessandrifrancesco seizuresandsepsisanarrativereview AT badenesrafael seizuresandsepsisanarrativereview AT bilottafederico seizuresandsepsisanarrativereview |