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Metabolic encephalopathy

MedGen UID:
647
•Concept ID:
C0006112
•
Disease or Syndrome
Synonyms: Brain Disease, Metabolic; Brain Diseases, Metabolic; Brain Disorder, Metabolic; Brain Disorders, Metabolic; Brain Metabolic Disorder; Brain Metabolic Disorders; Brain Syndrome, Metabolic; Encephalopathies, Metabolic; Encephalopathy, Metabolic; Metabolic Brain Disease; Metabolic Brain Diseases; Metabolic Brain Disorder; Metabolic Brain Disorders; Metabolic Brain Syndrome; Metabolic Brain Syndromes; Metabolic Disorder, Brain; Metabolic Disorders, Brain; Metabolic Encephalopathies; Metabolic Encephalopathy
SNOMED CT: Metabolic encephalopathy (50122000); Metabolic brain syndrome (50122000)

Definition

A group of neurologic disorders caused by alterations to the biochemical functioning of the brain. They are characterized by an altered level of consciousness and depressed cerebral functioning. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMetabolic encephalopathy

Professional guidelines

PubMed

Moving Beyond Metabolic Encephalopathy: An Update on Delirium Prevention, Workup, and Management.
Brown EG, Douglas VC
Semin Neurol 2015 Dec;35(6):646-55. Epub 2015 Nov 23 doi: 10.1055/s-0035-1564685. PMID: 26595865
Sepsis-associated encephalopathy and its differential diagnosis.
Iacobone E, Bailly-Salin J, Polito A, Friedman D, Stevens RD, Sharshar T
Crit Care Med 2009 Oct;37(10 Suppl):S331-6. doi: 10.1097/CCM.0b013e3181b6ed58. PMID: 20046118
Septic encephalopathy. Etiology and management.
Hasselgren PO, Fischer JE
Intensive Care Med 1986;12(1):13-6. doi: 10.1007/BF00315361. PMID: 2872241

Recent clinical studies

Etiology

Toxic leukoencephalopathies.
Bandeira GA, Lucato LT
Handb Clin Neurol 2024;204:455-486. doi: 10.1016/B978-0-323-99209-1.00006-5. PMID: 39322394
Pre-Hospital Diagnosis in Mobile Stroke Unit.
Ramanathan RS, Wisco D, Vela-Duarte D, Zafar A, Taqui A, Winners S, Buletko AB, Hustey F, Reimer A, Russman A, Uchino K, Hussain MS
J Stroke Cerebrovasc Dis 2021 Jul;30(7):105801. Epub 2021 Apr 18 doi: 10.1016/j.jstrokecerebrovasdis.2021.105801. PMID: 33878546
Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial.
Diéras V, Miles D, Verma S, Pegram M, Welslau M, Baselga J, Krop IE, Blackwell K, Hoersch S, Xu J, Green M, Gianni L
Lancet Oncol 2017 Jun;18(6):732-742. Epub 2017 May 16 doi: 10.1016/S1470-2045(17)30312-1. PMID: 28526536Free PMC Article
Neurologic Complications in the Intensive Care Unit.
Rubinos C, Ruland S
Curr Neurol Neurosci Rep 2016 Jun;16(6):57. doi: 10.1007/s11910-016-0651-8. PMID: 27098953
Metabolic encephalopathies.
Kunze K
J Neurol 2002 Sep;249(9):1150-9. doi: 10.1007/s00415-002-0869-z. PMID: 12242532

Diagnosis

Toxic leukoencephalopathies.
Bandeira GA, Lucato LT
Handb Clin Neurol 2024;204:455-486. doi: 10.1016/B978-0-323-99209-1.00006-5. PMID: 39322394
Electroencephalography as a Biomarker of Prognosis in Acute Brain Injury.
Rubinos C, Bruzzone MJ, Viswanathan V, Figueredo L, Maciel CB, LaRoche S
Semin Neurol 2023 Oct;43(5):675-688. Epub 2023 Oct 13 doi: 10.1055/s-0043-1775816. PMID: 37832589
Toxic-metabolic encephalopathy in adults: Critical discussion and pragmatical diagnostic approach.
Le Guennec L, Marois C, Demeret S, Wijdicks EFM, Weiss N
Rev Neurol (Paris) 2022 Jan-Feb;178(1-2):93-104. Epub 2022 Jan 4 doi: 10.1016/j.neurol.2021.11.007. PMID: 34996631
Metabolic encephalopathies.
Angel MJ, Young GB
Neurol Clin 2011 Nov;29(4):837-82. doi: 10.1016/j.ncl.2011.08.002. PMID: 22032664
Reye syndrome.
De Vivo DC
Neurol Clin 1985 Feb;3(1):95-115. doi: 10.1016/S0733-8619(18)31058-2. PMID: 3887130Free PMC Article

Therapy

Identifying encephalopathies from acute metabolic derangements.
Wijdicks EFM
J Intern Med 2022 Dec;292(6):846-857. Epub 2022 Jul 9 doi: 10.1111/joim.13538. PMID: 35809045
Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial.
Diéras V, Miles D, Verma S, Pegram M, Welslau M, Baselga J, Krop IE, Blackwell K, Hoersch S, Xu J, Green M, Gianni L
Lancet Oncol 2017 Jun;18(6):732-742. Epub 2017 May 16 doi: 10.1016/S1470-2045(17)30312-1. PMID: 28526536Free PMC Article
The EEG in metabolic encephalopathy and coma.
Kaplan PW
J Clin Neurophysiol 2004 Sep-Oct;21(5):307-18. PMID: 15592005
Celecoxib-induced methemoglobinemia.
Kaushik P, Zuckerman SJ, Campo NJ, Banda VR, Hayes SD, Kaushik R
Ann Pharmacother 2004 Oct;38(10):1635-8. Epub 2004 Aug 24 doi: 10.1345/aph.1E212. PMID: 15328400
Reye syndrome.
De Vivo DC
Neurol Clin 1985 Feb;3(1):95-115. doi: 10.1016/S0733-8619(18)31058-2. PMID: 3887130Free PMC Article

Prognosis

Toxic leukoencephalopathies.
Bandeira GA, Lucato LT
Handb Clin Neurol 2024;204:455-486. doi: 10.1016/B978-0-323-99209-1.00006-5. PMID: 39322394
Electroencephalography as a Biomarker of Prognosis in Acute Brain Injury.
Rubinos C, Bruzzone MJ, Viswanathan V, Figueredo L, Maciel CB, LaRoche S
Semin Neurol 2023 Oct;43(5):675-688. Epub 2023 Oct 13 doi: 10.1055/s-0043-1775816. PMID: 37832589
Identifying encephalopathies from acute metabolic derangements.
Wijdicks EFM
J Intern Med 2022 Dec;292(6):846-857. Epub 2022 Jul 9 doi: 10.1111/joim.13538. PMID: 35809045
Toxic-metabolic encephalopathy in adults: Critical discussion and pragmatical diagnostic approach.
Le Guennec L, Marois C, Demeret S, Wijdicks EFM, Weiss N
Rev Neurol (Paris) 2022 Jan-Feb;178(1-2):93-104. Epub 2022 Jan 4 doi: 10.1016/j.neurol.2021.11.007. PMID: 34996631
Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial.
Diéras V, Miles D, Verma S, Pegram M, Welslau M, Baselga J, Krop IE, Blackwell K, Hoersch S, Xu J, Green M, Gianni L
Lancet Oncol 2017 Jun;18(6):732-742. Epub 2017 May 16 doi: 10.1016/S1470-2045(17)30312-1. PMID: 28526536Free PMC Article

Clinical prediction guides

Electroencephalography as a Biomarker of Prognosis in Acute Brain Injury.
Rubinos C, Bruzzone MJ, Viswanathan V, Figueredo L, Maciel CB, LaRoche S
Semin Neurol 2023 Oct;43(5):675-688. Epub 2023 Oct 13 doi: 10.1055/s-0043-1775816. PMID: 37832589
Identifying encephalopathies from acute metabolic derangements.
Wijdicks EFM
J Intern Med 2022 Dec;292(6):846-857. Epub 2022 Jul 9 doi: 10.1111/joim.13538. PMID: 35809045
Altered mental status in COVID-19.
Antoniello D, Milstein MJ, Dardick J, Fernandez-Torres J, Lu J, Patel N, Esenwa C
J Neurol 2022 Jan;269(1):12-18. Epub 2021 Jun 3 doi: 10.1007/s00415-021-10623-5. PMID: 34085094Free PMC Article
Acute Acquired Metabolic Encephalopathy Based on Diffusion MRI.
Jeon SJ, Choi SS, Kim HY, Yu IK
Korean J Radiol 2021 Dec;22(12):2034-2051. Epub 2021 Aug 31 doi: 10.3348/kjr.2019.0303. PMID: 34564957Free PMC Article
The EEG in metabolic encephalopathy and coma.
Kaplan PW
J Clin Neurophysiol 2004 Sep-Oct;21(5):307-18. PMID: 15592005

Recent systematic reviews

Phenotypic spectrum of short-chain enoyl-Coa hydratase-1 (ECHS1) deficiency.
Masnada S, Parazzini C, Bini P, Barbarini M, Alberti L, Valente M, Chiapparini L, De Silvestri A, Doneda C, Iascone M, Saielli LA, Cereda C, Veggiotti P, Corbetta C, Tonduti D
Eur J Paediatr Neurol 2020 Sep;28:151-158. Epub 2020 Jul 29 doi: 10.1016/j.ejpn.2020.07.007. PMID: 32800686
Acute Opiate Overdose: An Update on Management Strategies in Emergency Department and Critical Care Unit.
Parthvi R, Agrawal A, Khanijo S, Tsegaye A, Talwar A
Am J Ther 2019 May/Jun;26(3):e380-e387. doi: 10.1097/MJT.0000000000000681. PMID: 28952972
Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM.
Claassen J, Taccone FS, Horn P, Holtkamp M, Stocchetti N, Oddo M; Neurointensive Care Section of the European Society of Intensive Care Medicine
Intensive Care Med 2013 Aug;39(8):1337-51. Epub 2013 May 8 doi: 10.1007/s00134-013-2938-4. PMID: 23653183

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