(Encephalopathy, Hepatic; Portal-Systemic Encephalopathy; Encephalopathy, Portal-Systemic)
|Oxygen and Blood Flow to the Brain|
|If the liver is not working properly, toxins can build up in the blood. The toxic blood travels to the brain, affecting the brain's ability to function.|
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- Certain conditions that affect the levels of fluids and electrolytes (such as hyponatremia, hyperkalemia)
- Kidney failure
- Gastrointestinal bleeding
- Certain medicines (such as sedatives, anti-epileptics)
- Hepatitis (infectious or autoimmune)
- Changes in behavior and personality
- Shortened attention span
- Depression and anxiety
- Slurred speech
- Tremor (particularly a flapping tremor of the hands)
- Asterixis (rapid momentary loss of tone in the muscles)
- Stupor or coma
- Liver function tests
- Kidney function tests
- Imaging tests of the liver (may be done)
Hospitalization and Emergency Care
- Neutralize toxins
- Treat the condition causing encephalopathy
- Reduce recurrence
- Get early treatment for liver problems.
- If you have a disease (such as cirrhosis), see your doctor regularly.
- Follow your doctor's instructions or product recommendations for any medication. Avoid overdosing.
- Avoid being exposed to poisons or toxins.
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
Canadian Liver Foundation http://www.liver.ca
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html
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 (review). 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. Review.
Hepatic encephalopathy. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 12, 2012. Accessed September, 2012.
Highleyman L. Hepatitis C. HCV Advocate website. Available at: http://www.hcvadvocate.org/hepatitis/hepC/hepatic%5Fencephalopathy.html. Published 2005. Accessed September, 2012.
Juretschke L. Kernicterus: still a concern. Neonatal Netw. 2005;24:7-9.
Lizardi-Cervera J, Almeda P, Guevara L, et al. Hepatic encephalopathy: a review. Ann Hepatol. 2003;2:122-130. Review.
Metabolic encephalopathy. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 11, 2009. Accessed September, 2012.
Siegal GJ, Agranoff BW, Albers RW, Uhler MD. Metabolic encephalopathies. In: Basic Neurochemistry: Molecular, Cellular, and Medical Aspects. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1999.
Toftengi F, Larsen F. Management of patients with fulminant hepatic failure and brain edema. Metab Brain Dis. 2004;19:207-214.
4/2/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: FDA approves new use of Xifaxan for patients with liver disease. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm206104.htm. Published March 24, 2010. Accessed April 2, 2010.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012 -
- Update Date: 03/25/2013 -