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Hepatic Encephalopathy01:29

Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
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Posterior reversible encephalopathy syndrome.

John H Pula1, Eric Eggenberger

  • 1Department of Neurology and Ophthalmology, Michigan State University, Lansing, Michigan, USA.

Current Opinion in Ophthalmology
|October 16, 2008
PubMed
Summary
This summary is machine-generated.

Posterior reversible encephalopathy syndrome (PRES) can cause visual loss, often reversible with prompt treatment of underlying causes like hypertension or eclampsia. Ophthalmologists play a key role in diagnosing this condition.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Radiology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is increasingly recognized with expanding associations and understanding of its pathophysiology.
  • Initially considered a posterior subcortical disease, PRES can affect various brain regions, including gray matter and the spinal cord.

Purpose of the Study:

  • To review the presentation and clinical management of visual loss in patients with PRES.
  • To emphasize the importance of prompt diagnosis and treatment for visual recovery.

Main Methods:

  • Review of recent literature on PRES, including case reports and pathophysiological studies.
  • Emphasis on Magnetic Resonance Imaging (MRI) as a key diagnostic tool.

Main Results:

  • PRES is associated with acute hypertension, eclampsia, immunosuppressive drugs, infections, and autoimmune diseases.
  • The syndrome results from vasogenic edema in the central nervous system, likely due to impaired cerebral vascular autoregulation.
  • Visual loss is a frequent symptom, but often reversible with treatment targeting the causative factors.

Conclusions:

  • Ophthalmologists may be the first to diagnose PRES when evaluating visual loss.
  • Prompt identification and management of underlying causes are crucial for reversing neurological and visual deficits.
  • MRI is essential for diagnosing PRES and identifying its cerebral origins.