encephalopathy
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Introduction
syndrome of global brain dysfunction
Etiology
- infection
- metabolic brain disease (mitochondrial dysfunction)
- increased intracranial pressure
- toxins
- chronic traumatic brain injury
- malnutrition
- cerebral anoxia[2]
- autoimmune encephalopathy (anti-LGI1 > anti-IgLON5)[3]
Clinical manifestations
- altered mental status
- common
- progressive memory loss & cognitive impairment
- subtle personality changes
- inability to concentrate
- fatigue, lethargy
- headache[4]
- progressive loss of consciousness
- other
Laboratory
- complete blood count
- serum electrolytes
- serum glucose
- serum calcium
- renal function tests
- liver function tests, serum albumin
- plasma ammonia
- serum TSH
- serum C-reactive protein or erythrocyte sedimentation rate
- urinalysis & urine toxicology screen
- arterial blood gas
- lumbar puncture with CSF analysis
- HIV testing
Diagnostic procedures
Radiology
- neuroimaging (MRI)
- autoimmune encephalopathy in the elderly may not be associated with signs of inflammation[3]
Management
- symptomatic[2]
More general terms
More specific terms
- chronic traumatic encephalopathy (CTE)
- EMPF encephalopathy; encephalopathy, lethal, due to defective mitochondrial & peroxisomal fission (EMPF)
- encephalitis
- encephalomalacia
- ethylmalonic encephalopathy
- familial encephalopathy with neuroserpin inclusion bodies
- Hashimoto encephalopathy
- hyperglycemic-hyperosmolar syndrome; hyperglycemic-hyperosmolar nonketotic coma (HHNC)
- infantile epileptic encephalopathy
- isolated (primary) central nervous system vasculitis (angiitis) (PACNS)
- leukoencephalopathy
- limbic-predominant age-related TDP-43 encephalopathy (LATE)
- metabolic encephalopathy; toxic encephalopathy
- mitochondrial encephalomyopathy
- myoclonic encephalopathy
- portal systemic encephalopathy (PSE)
- posterior reversible encephalopathy syndrome (PRES)
- Reye's syndrome
- transmissible spongiform encephalopathy (prion disease)
- Wernicke's syndrome (Wernicke's encephalopathy)
Additional terms
References
- ↑ Wikipedia: Encephalopathy http://en.wikipedia.org/wiki/Encephalopathy
- ↑ 2.0 2.1 2.2 National Institute of Neurological Disorders and Stroke (NINDS) NINDS Encephalopathy Information Page http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm
- ↑ 3.0 3.1 3.2 Probasco JC Antibody-Associated CNS Syndromes Without Inflammation in Elders. NEJM Journal Watch. Nov 7, 2017 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
Escudero DEscudero D, Guasp M, Arino H et al. Antibody-associated CNS syndromes without signs of inflammation in the elderly. Neurology 2017 Oct 3; 89:1471 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28878050 - ↑ 4.0 4.1 Blum SM, Prust ML, Patel R et al Stream of Consciousness. N Engl J Med 2018; 378:1336-1342. April 5, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29617591 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcps1714950