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Hepatic Encephalopathy
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Journal Article
Hepatic Encephalopathy
2016
Overview
The brain dysfunction associated with liver failure can have diverse manifestations. The main pathogenesis is metabolic derangement of cell function and brain edema. Prompt recognition and treatment may reverse, at least partially, some of the abnormalities.
When the liver fails, brain function changes. Acute-on-chronic liver failure is manifested initially as abnormal behavior and compromised cognition. In the absence of preexisting disease, acute, severe liver failure may cause the brain to swell, with patients becoming comatose and losing brain function altogether. Hepatic encephalopathy in patients with chronic liver disease is potentially reversible and manageable, but new, acute (fulminant) hepatic encephalopathy with rapidly rising blood ammonia levels is more difficult to control because of diffuse brain edema and structural brain-stem injury.
Although the onset of hepatic encephalopathy can rarely be pinpointed clinically, it is a clinical landmark in . . .
Publisher
Massachusetts Medical Society
