Acute Metabolic Encephalopathies

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Eelco Wijdicks, a neurology professor and neurointensivist, about acute metabolic encephalopathies. They discuss the challenges of using the term "metabolic encephalopathy" as a wastebasket diagnosis in the ICU, emphasizing the importance of a thorough neurological examination, updated imaging like MRI scans, and ruling out confounding factors such as drugs and electrolyte imbalances. Dr. Wijdicks highlights the significance of considering structural brain injuries and the potential for delayed neurological improvement even after correcting metabolic derangements. They also explore the impact of various organ failures on the brain and the complexities of diagnosing and managing encephalopathy in critically ill patients, including the role of EEG and CSF analysis.