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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...

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Detalles Bibliográficos
Autores principales: Alessandri, Francesco, Badenes, Rafael, Bilotta, Federico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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
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