Hepatic encephalopathy

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Contents

Hepatic Encephalopathy

Background

From wikipedia:Hepatic_encephalopathy

Hepatic encephalopathy (sometimes hepatoencephalopathy or portosystemic encephalopathy) is a potentially-reversible neuropsychiatric abnormality in the setting of liver failure, whether chronic (as in cirrhosis), or acutely. It can be diagnosed only after exclusion of other neurological, psychiatric, infectious, and metabolic etiologies.

With severe liver impairment, toxic substances normally removed by the liver accumulate in the blood and impair the function of brain cells. If there is also portal hypertension, and subsequent bypassing of the liver filtration system of blood flowing in from the intestines, these toxic substances can travel directly to the brain, without being modified or purified. Signs can include impaired cognition, a flapping tremor (asterixis), and a decreased level of consciousness including coma (hepatic coma or coma hepaticum), cerebral edema, and, ultimately, death.

Current Treatments

Rifaximin

Further Reading

wikipedia:Hepatic_encephalopathy

MedlinePlus

Merck Manuals

eMedicine Gastroenterology