Hepatic encephalopathy is a neuropsychiatric syndrome caused by liver failure that results in a reversible decrease in brain function. It is most common in patients with cirrhosis. Symptoms include disturbances in consciousness, personality changes, neurological signs like tremors, and confusion. It is caused by factors that increase the level of toxins in the blood that are normally processed by the liver, such as infections, bleeding, or kidney failure. Diagnosis is clinical but may include blood tests showing elevated ammonia levels or EEG changes. Treatment focuses on removing the precipitating cause and aiding liver function.
2. Hepatic encephalopathy
Hepatic encephalopathy is a neuropsychiatric
syndrome caused by hepatic insufficiency
It represents a reversible decrease in neurologic
function, based upon the disorder of metabolism
which are caused by severe decompensated liver
disease
“Portal-systemic encephalopathy” - patients with
portal hypertension abnormal shunting of blood
It occurs most often in patients with cirrhosis but
also occur in acute hepatic failure.
13. Clinical Features of hepatic
encephalopathy:
A Disturbance in consciousness
Disturbances in sleep rhythm.
Impaired memory/ apraxia
Mental confusion.
Apathy.
Drowsiness / Somnolence
Coma.
14. B. Changes Personality
Childish behavior.
May be aggressive out burst.
Euphoric.
Foetor hepaticus – Foul–smelling
breath associated with liver disease
due to mercaptans
15. C Neurological signs:
Flapping tremor / Asterixis (in pre
coma).
Exaggerated tendon reflex.
Extensor plantar reflex.
17. Investigations
Diagnosis is usually made clinically
No Pathognomonic liver function
abnormality
Elevation of blood ammonia
Hypokalaemia
EEG (Electroencephalogram)
CSF & CT Scan – Normal
Other Routine Investigations TC, DC, ESR, Hb, Na, k, Urea, Creatinine,
Prothrombin time