Hepatic encephalopathy - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Hepatic encephalopathy is a neuropsychiatric syndrome caused by acute or chronic advanced hepatic insufficiency.
Symptoms vary in severity from a mild alteration in mental state to coma but are often reversible with treatment.
Causation is thought to be multifactorial, resulting in brain exposure to ammonia that has bypassed the liver through portosystemic shunting.
Diagnosis is based on reported neurologic deficits combined with laboratory abnormalities showing severe liver dysfunction.
Treatment approaches include providing supportive care (such as preventing aspiration), correcting precipitating factors, and reducing gastrointestinal production of ammonia.

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Definition

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Citations

Key Articles

Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug;60(2):715-35.[Abstract][Full Text]
European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.[Abstract][Full Text]
Bajaj JS, O'Leary JG, Lai JC, et al. Acute-on-chronic liver failure clinical guidelines. Am J Gastroenterol. 2022 Feb 1;117(2):225-52.[Abstract][Full Text]

Referenced Articles

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2. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.[Abstract][Full Text]
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54. Bajaj JS, Schubert CM, Heuman DM, et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy. Gastroenterology. 2010 Jun;138(7):2332-40.[Abstract][Full Text]
55. Bajaj JS, Wade JB, Gibson DP, et al. The multi-dimensional burden of cirrhosis and hepatic encephalopathy on patients and caregivers. Am J Gastroenterol. 2011 Sep;106(9):1646-53.[Abstract][Full Text]
56. Bajaj JS, Hafeezullah M, Zadvornova Y, et al. The effect of fatigue on driving skills in patients with hepatic encephalopathy. Am J Gastroenterol. 2009 Apr;104(4):898-905.[Abstract]
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