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Chapter 10 - Neurological complications of systemic disorders

Published online by Cambridge University Press:  07 October 2011

S. Andrew Josephson
Affiliation:
University of California, San Francisco
W. David Freeman
Affiliation:
Mayo Clinic
David J. Likosky
Affiliation:
Evergreen Hospital Medical Center, Kirkland, WA
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Summary

Neurological symptoms can occur in a multitude of infectious, inflammatory, autoimmune or metabolic disorders. In hospitalized patients, neurological manifestations of systemic disorders may include confusion, depressed level of consciousness or coma, focal neurological deficits, seizures, headaches or meningeal signs. Thyroid disease is present in approximately 1-2% of hospitalized patients. Systemic lupus erythematosis (SLE) is an autoimmune disorder that affects multiple organ systems. Neurological involvement is not a requirement for diagnosis, but the presence of seizures or psychosis without any plausible alternate explanation fulfills one of the 11 American College of Rheumatology (ACR) diagnostic criteria. Hepatic encephalopathy (HE) encompasses a wide range of neurological findings in the context of acute or chronic liver failure. Studies of liver transplant patients show a rate of neurological complications between 20 and 30%, with encephalopathy (11-15%) and seizure (6%) accounting for the majority of events.
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Publisher: Cambridge University Press
Print publication year: 2011

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