Sepsis-associated encephalopathy

Sepsis-associated encephalopathy (SAE), also known as sepsis-associated brain dysfunction or septic encephalopathy, is a type of infectious disease-associated encephalopathy (IDAE).^[1][2][3][4] It is an umbrella term referring to neurological complications following sepsis.^[1] The condition is common but poorly understood.^[2][3] Approximately 70% of people with sepsis experience SAE.^[1] The diagnosis of SAE is difficult, with no well-established biomarkers, and it is currently a diagnosis of exclusion based on clinical symptoms.^[1][2] However, electroencephalogram (EEG) may be helpful in aiding diagnosis.^[2]

Acute symptoms of SAE can include sickness behavior, lethargy, delirium, cognitive, memory, and attention impairment, depression, anxiety, agitation, motor problems, seizures, and, in severe cases, coma.^[1][2] Post-acute symptoms of SAE can include cognitive and memory deficits and neuromyopathy, among others.^[1]

There are currently no well-accepted treatments for the prevention or treatment of SAE symptoms, and treatment is largely symptom-based.^[1][2] In the acute phase, certain medications may aggravate symptoms and may be avoided, such as anticholinergics, antihistamines, sedatives, benzodiazepines, antipsychotics, and anticonvulsants (in those without seizures).^[1] Certain medications such as statins, the antidepressant fluoxetine, and resveratrol may reduce neuroinflammation and the acute and long-term symptoms of SAE.^[1] However, these findings are based on animal studies, and more research is needed in this area.^[1][2] In addition to the preceding, the serotonin 5-HT₂ receptor agonist and serotonergic psychedelic 25H-NBOMe has been found to attenuate sepsis-associated depressive-like behavior in rodents, as measured by the forced swim test (FST).^[5][6]

The term "sepsis-associated encephalopathy" was first used by 1990 and this was when the first comprehensive study of this condition was published.^[7][4]