Hepatic Encephalopathy
Hepatic encephalopathy is a serious brain disorder that can arise in individuals suffering from liver disease. It occurs when the liver fails to filter out toxins from the blood, leading to a buildup that affects brain function. Symptoms can begin mildly, with changes in mood or sleep, confusion, and memory issues, but may progress to more severe manifestations such as slurred speech, agitation, and even coma. Factors contributing to hepatic encephalopathy include liver conditions like cirrhosis or hepatitis, as well as situations causing reduced blood flow to the liver. Diagnosis typically involves blood tests, imaging, and assessments of brain activity, while treatment is often urgent and conducted in a hospital setting. Addressing the underlying causes is critical, and while acute cases may be reversible, chronic forms can lead to worsening symptoms and complications. Preventive measures focus on maintaining liver health by avoiding excessive alcohol consumption and intravenous drug use. Understanding hepatic encephalopathy is crucial for timely intervention and management of this potentially life-threatening condition.
On this Page
Subject Terms
Hepatic Encephalopathy
Hepatic encephalopathy is a disorder of the brain that may develop in people with liver disease. Symptoms are progressive and may include personality changes, intellectual impairment, memory loss, and coma. The disorder can occur in individuals with acute or chronic liver disease or inadequate blood flow to the liver. In hepatic encephalopathy, toxins that are normally evacuated from the body by the liver instead accumulate in the blood and eventually infiltrate the brain. Many of the symptoms of hepatic encephalopathy can be reversed if diagnosis and treatment are made early during the course of the disease.
Overview
Hepatic encephalopathy is a degeneration in brain function that results when the liver is unable to remove toxic substances from the blood. These toxins are made up of waste products produced by the body or external substances ingested into the body that cannot be properly processed through the liver.
While the exact cause of hepatic encephalopathy is unknown, the condition is associated with disorders that reduce liver function, such as cirrhosis or hepatitis, and by conditions in which blood circulation is diverted from the liver due to irregular body function. Hepatic encephalopathy also may present suddenly in individuals with no prior history of liver problems if damage to the liver occurs.
Hepatic encephalopathy may begin with relatively mild symptoms, such as altered mood or sleep patterns, mild confusion or forgetfulness, sweet- or musty-smelling breath, lack of concentration, or diminished hand function. Symptoms become more severe once the disease progresses. In some cases, severe symptoms may be the first indication of the disorder. The more severe symptoms of hepatic encephalopathy may include slurred speech, significant personality changes, disorientation, drowsiness or confusion, sluggish movement or shaking hands, and agitation. Sometimes seizure or coma will occur. In cases of coma, the majority of patients do not survive.
Hepatic encephalopathy is diagnosed through blood tests, imaging, electroencephalogram (a recording of the brain’s electrical activity), and liver-function tests. Treatment is usually administered in a hospital and is considered to be a medical emergency. The priority of treatment is to identify and address the causes of the patient’s hepatic encephalopathy. Treatment approaches vary depending on the cause and may include procedures to stop internal gastrointestinal bleeding, heal infection, and/or improve kidney function.
For individuals with acute, or sudden-onset, hepatic encephalopathy, the condition is often treatable as a one-time health crisis. The prognosis for people with chronic forms of the disorder is less favorable, as the symptoms frequently worsen or continue to return after treatment. Critical complications of hepatic encephalopathy may include brain swelling, cardiovascular collapse, kidney failure, respiratory failure, permanent nervous-system damage, or a potentially deadly blood infection known as sepsis.
The main preventive measures for hepatic encephalopathy involve protecting against liver disorders by managing factors that can be controlled, such as avoiding heavy drinking of alcohol and intravenous drug use.
Bibliography
Acton, Q. Ashton, gen. ed. Hepatic Encephalopathy: New Insights for the Healthcare Professional. 2013 ed. Atlanta: ScholarlyEds., 2013. Digital file.
“Hepatic Encephalopathy.” Upd. George F. Longstreth. Rev. David Zieve and Bethanne Black. MedlinePlus. Natl. Lib. of Medicine, 13 Oct. 2013. Web. 18 June 2015.
McHale, Teri J., Henry V. Soper, and Carol Swann. “Encephalopathy.” The Encyclopedia of Neuropsychological Disorders. Ed. Chad A. Noggle, Raymond S. Dean, and Arthur M. Horton Jr. New York: Springer, 2012. 288–91. Print.
Mullen, Kevin D., and Ravi K. Prakash, eds. Hepatic Encephalopathy. New York: Humana, 2012. Print.
Mullen, Kevin D., and Ravi K. Prakash, eds. Hepatic Encephalopathy: An Update. Spec. issue of Clinics in Liver Disease 16.1 (2012): 1–182. Print.
“What Is Hepatic Encephalopathy?” HE 123. Amer. Liver Foundation, n.d. Web. 18 June 2015.