Hocker Sara E, Wijdicks Eelco F M
Continuum (Minneap Minn). 2014 Jun;20(3 Neurology of Systemic Disease):598-613. doi: 10.1212/01.CON.0000450968.53581.ff.
This article reviews the current understanding of sepsis, a critical and often fatal illness that results from infection and multiorgan failure and impacts the brain, peripheral nervous system, and muscle.
Encephalopathy occurs early in association with sepsis, and its severity correlates with mortality. Neuroimaging in patients with CNS manifestations is typically normal. EEG is nonspecific. EMG is commonly diagnostic, showing a combination of nerve and muscle injury already early in the clinical course. Rapid recognition and correction of reversible causes of encephalopathy and avoidance of risk factors for intensive care unit-acquired weakness may limit sequelae. Major deficiencies in our understanding of the complications of sepsis remain. Studies to improve the recognition and rehabilitation of these patients are imperative in a clinical syndrome affecting countless patients each year.
The risk of later cognitive and physical disability may be increased after sepsis; therefore, attention to neurologic complications is urgent.
本文综述了目前对脓毒症的认识，脓毒症是一种由感染和多器官功能衰竭导致的危急且常致命的疾病，会影响大脑、周围神经系统和肌肉。
脑病在脓毒症早期就会出现，其严重程度与死亡率相关。有中枢神经系统表现的患者神经影像学检查通常正常。脑电图无特异性。肌电图通常具有诊断价值，在临床病程早期就显示出神经和肌肉损伤的综合表现。快速识别和纠正脑病的可逆病因，并避免重症监护病房获得性肌无力的危险因素，可能会减少后遗症。我们对脓毒症并发症的认识仍存在重大不足。对于这种每年影响无数患者的临床综合征，开展旨在改善这些患者的识别和康复的研究势在必行。
脓毒症后后期出现认知和身体残疾的风险可能会增加；因此，对神经并发症的关注刻不容缓。
