Neurological disorders as EHEC symptoms

Neurological disorders as symptoms of EHEC infection

08/06/2011

The current EHEC epidemic continues to cause concern amongst the population. Although most Germans are now considerably sensitized to possible EHEC symptoms such as watery, bloody diarrhea and possible kidney failure, but the threat of neurological sequelae are unknown to many today. Therefore, experts of the German Society of Neurology warn of the possible neurological symptoms of EHEC infection.

Experts warn against severe neurological damage caused by EHEC. While the focus in public perception in the current wave of infection is more on EHEC symptoms such as bloody diarrhea and life-threatening kidney failure, the possible neurological damage is a not to be underestimated risk of diseases caused by the new particularly aggressive EHEC pathogen HUSEC 041, said Prof Dr. med. Joachim Röther, Head of Neurology at the Asklepios Clinic in Hamburg-Altona in a press release by the German Neurological Society.

EHEC causes epileptic seizures and impaired consciousness
In addition to the well-discussed EHEC symptoms, such as diarrhea and kidney disease, EHEC infection can cause significant neurological damage, the experts at the German Neurological Society explained. Prof. Dr. According to Röther shows „About half of all patients with HUS have serious neurological courses“. The EHEC infections, according to Dr. med. Röther „three neurological failure patterns“ conditionally: „Epileptic seizures due to damage to the cerebral cortex, brain stem symptoms such as motor disorders“ and disorders „consciousness with dual vision or TIA disorders (transient ischemic attacks), so transient stroke symptoms.“ Responsible for the occurrence of neurological disorders, according to the experts probably the so-called Shiga toxin, which is released by the EHEC pathogens.

Severe neurological disorders due to EHEC infection
Especially patients in whom the EHEC infection takes a particularly difficult course, the German Society of Neurology are at risk of serious neurological symptoms and sequelae. According to Dr. Röther Most patients who suffer from haemolytic uraemic syndrome (HUS) as a result of EHEC infection are also at significant neurological impairment. In the neurological department of the Asklepios Clinic in Hamburg-Altona, therefore, 16 EHEC patients are currently being treated for neurological intensive care, the expert emphasized. Although, according to Dr. Röther „The fact is that half of HUS patients show neurological deficits“, which represents a much greater proportion than previous EHEC outbreaks, the expert showed „optimistic that most sufferers also overcome their problems such as confusion, speech and movement disorders.“ Overall, however, the course of the disease varies considerably from patient to patient „even the typical course of the disease - two or three days after the diarrhea HUS symptoms appear, two to three days later neurological deficits are added -“ does not apply to some patients, explained the expert. Partially, the nerve cells of the patients would have „without any HUS symptom“ Strike, Dr. Rooter continues.

Involve neurologists early in the treatment of EHEC patients
According to the experts of the German Neurological Society, it is particularly worrying that the neurological status of EHEC patients often does not improve despite early treatment with plasmapheresis (blood washing), but has instead partly worsened further. Therefore, Prof. Dr. Röther together with the Head of the Clinic and Polyclinic for Neurology of the University Hospital in Hamburg-Eppendorf (UKE), Prof. Dr. med. Christian Gerloff, in a press release of the German Neurological Society, said that neurologists are involved in the treatment of EHEC patients at an early stage. The early involvement is particularly important because in the patients treated neurological disorders „not necessarily occur at the end of an escalating disease sequence“, rather „already develop simultaneously with gastroenterological and nephrological symptoms“ Prof. Dr. Christian Gerloff.

Treatment of EHEC-related neurological disorders
In the treatment of EHEC-related neurological disorders in addition to the existing drugs for strokes and epilepsy and the new drug eculizumab is used to stop the particularly dangerous degradation of the blood cells. Although no miracles are to be expected on the basis of eculizumab therapy, „We observe a slight improvement in the condition of the patients treated with it“, explained Dr. Redder. According to the expert, it may be „just too early to see the full effect.“ Overall, according to the German Neurological Association, the severity of EHEC symptoms and the onset of neurological deficits should form the basis for a decision on the use of the new drug eculizumab. Accompanying the experts is always to consider a preventive anti-seizure therapy as soon as the first neurological disorders occur. Anti-seizure therapy can help prevent epileptic seizures that affect more than 65 percent of EHEC patients with HUS disease and may require an artificial coma. Röther and dr. Gerloff. The experts conclude that by timely consultation with a neurologist „possible permanent damage in the nervous system“ can be largely prevented in an EHEC infection. (Fp)

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