Hepatic encephalopathy (confusion liver failure)

Head | Neurology | Hepatic encephalopathy (confusion liver failure) (Disease)


Hepatic encephalopathy is a syndrome observed in patients with cirrhosis. Hepatic encephalopathy is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, after exclusion of other known brain disease.

An important job of the liver is to change toxic substances that are either made by the body or taken into the body (such as medicines) and make them harmless. However, when the liver is damaged, these poisons may build up in the bloodstream.

Symptoms occur gradually and include confusion, agitation, change in behavior, poor concentration, sleeping problems, personality changes, slurred speech, abnormal movements of the arms and legs, seizures, and coma.

Causes and Risk factors

The disease is caused by the build up of toxic substances that are normally cleared by the liver. The disorder is triggered by infections, dehydration, bleeding from the intestinal tract, eating too much protein, blood chemistry problems, low oxygen levels, kidney failure, use of medications that suppress the central nervous system (such as barbiturates or benzodiazepine tranquilizers), shunt placement or surgery.

Hepatic encephalopathy is characterized by personality changes, intellectual impairment, and a depressed level of consciousness. An important prerequisite for the syndrome is diversion of portal blood into the systemic circulation through portosystemic collateral vessels.

Diagnosis and Treatment

Hepatic encephalopathy may become a medical emergency. Hospitalization is required. The first step is to identify and treat any factors that may have caused hepatic encephalopathy.

Treatment for cirrhosis may include: strict avoidance of alcohol; avoidance of acetaminophen and other nonprescription medications that a metabolized by the liver. A liver disease diet include: low sodium diet; low protein diet; high carbohydrate diet;...

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