Occurrence of nervous system involvement in SIRS.
Systemic inflammatory response syndrome (SIRS) is a medical condition in which the all-organ microcirculation is affected including nervous system. We describe neurological findings in 64 patients with SIRS at Hospital das Clínicas of Sao Paulo University School of Medicine; 45.3% were male and 54.7% female; their age ranged from 16 to 95 years old. SIRS was caused by infection in 68.8% of patients, trauma in 10.9%, burns in 7.8%, and elective surgery in 4.7%. The central nervous system involvement occurred in 56.3% of patients and was characterized as encephalopathy in 75%, seizures in 13.9%, non-epileptic myoclonus in 2.8%, and ischemic stroke in 8.3%. The magnetic resonance imaging, cerebrospinal fluid and electroencephalographic changes were unremarkable in encephalopathic patients. Neuromuscular disorders were diagnosed in 43.7%. Critical ill polyneuropathy was characterized in 57.1%, critical ill myopathy in 32.1%, demyelinating neuropathy in 7.2%, and pure motor neuropathy in 3.6%. Nerve and muscle pathological studies dismissed inflammatory abnormalities. The identification of these conditions has important economic implications and may change the critically ill patients' prognosis.
Marchiori
Paulo E
PE
Department of Neurology, Hospital das Clínicas, Sao Paulo University School of Medicine, São Paulo, Brazil. marchiori@hcnet.usp.br
Lino
Angelina M M
AM
Hirata
Maria T A
MT
Carvalho
Nise B
NB
Brotto
Mario W I
MW
Scaff
Milberto
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology / Q000503:physiopathology; D002490:Central Nervous System / Q000473:pathology / Q000503:physiopathology; D015897:Comorbidity; D004660:Encephalitis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000453:epidemiology / Q000503:physiopathology; D009420:Nervous System / Q000473:pathology / Q000503:physiopathology*; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000503:physiopathology; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology; D011115:Polyneuropathies / Q000453:epidemiology / Q000503:physiopathology; D011129:Polyradiculoneuropathy / Q000453:epidemiology / Q000503:physiopathology; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology* / Q000503:physiopathology