Hepatic Encephalopathy(Encephalopathy, Hepatic; Portal-Systemic Encephalopathy; Encephalopathy, Portal-Systemic)Pronounced: HEP-at-ik En-SEF-a-lo-PATH-ee
by
Cynthia M. Johnson, MA DefinitionHepatic encephalopathy is a problem with the brain that is caused by liver disease. The problem may be temporary or permanent.
CausesA liver with disease cannot filter the harmful items in blood. These toxins build up in the blood, which reaches the brain and affects the brain’s ability to work properly. Risk FactorsFactors that increase your chance of hepatic encephalopathy include:
SymptomsIn the early stages, you may not notice any symptoms. As the condition progresses, symptoms may include:
If you have liver problems and any of the above symptoms, call your doctor right away. DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. The condition of your nervous system will also be assessed. Your liver and kidney function may be assessed. This can be done with:
Your brain and nervous system may be assessed. This can be done with:
TreatmentHospitalization and Emergency CareThe initial treatment will focus on treating and trying to reverse the underlying problems. If possible, toxins in your blood will be removed or neutralized. MedicationsMedications may be used to:
Dietary RestrictionsChanges in your diet may be recommended. Tube feeding may be needed to supply nutrients, especially in the case of coma. TransplantationIf this condition is due to liver failure, you may need a liver transplant. PreventionTo help reduce your chance of hepatic encephalopathy:
RESOURCES:National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov References:Bernuau J. Acute liver failure: Avoidance of deleterious co-factors and early specific medical therapy for the liver are better than late intensive care for the brain.
J Hepatol. 2004;41:152-155. Butterworth RF. Role of circulating neurotoxins in the pathogenesis of hepatic encephalopathy: potential for improvement following their removal by liver assist devices.
Liver Int. 2003;23(suppl 3):5-9. Hepatic encephalopathy. Canadian Liver Foundation website. Available at: https://www.liver.ca/patients-caregivers/liver-diseases/hepatic-encephalopathy/. Accessed February 14, 2018. Hepatic encephalopathy. Cleveland Clinic website. Available at: ...(Click grey area to select URL) Updated August 2017. Accessed February 14, 2018.
Hepatic encephalopathy. EBSCO DynaMed Plus website. Available at:
http://www.dynamed...
. Updated November 1, 2016. Accessed February 14, 2018.
Liere V, Sandhu G, DeMorrow S. Recent advances in hepatic encephalopathy. F1000Res. 2017;6:1637. Lizardi-Cervera J, Almeda P, Guevara L, et al. Hepatic encephalopathy: a review.
Ann Hepatol. 2003;2:122-130. Toftengi F, Larsen F. Management of patients with fulminant hepatic failure and brain edema.
Metab Brain Dis. 2004;19:207-214. Last reviewed March 2018 by
EBSCO Medical Review Board
Rimas Lukas, MD Last Updated: 3/5/2014 |
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