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Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

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Published on: May 12, 2018

Iatrogenic hyperammonemia after anorexia.

Emily Welsh¹, Jan Kucera, Michael D Perloff

¹Department of Neurology, Boston University School of Medicine, MA 02118, USA.

Archives of Internal Medicine

|March 10, 2010

Summary

This summary is machine-generated.

High-protein supplements can cause hyperammonemia in patients with anorexia, leading to neurological symptoms. Stopping these supplements reverses the condition, suggesting supplement-associated hyperammonemia after cachectic episode (SHAKE) syndrome is common.

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Last Updated: Jun 15, 2026

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Published on: May 12, 2018

Area of Science:

Neurology
Gastroenterology
Clinical Nutrition

Background:

Anorexia nervosa and cachectic states often precede hospital admission.
Nutritional support, including high-protein supplements, is common in these patients.
Liver disease is typically absent in these cases.

Observation:

Two patients presented with anorexia followed by altered mental status and ataxia.
Hyperammonemia was detected after excluding other potential causes.
Standard liver function tests remained within normal limits.

Findings:

High-protein dietary supplements were identified as the cause of hyperammonemia.
Discontinuation of supplements led to symptom resolution and normalized ammonia levels.
This suggests a novel syndrome: supplement-associated hyperammonemia after cachectic episode (SHAKE).

Implications:

SHAKE syndrome may be an underrecognized cause of hyperammonemia in hospitalized patients.
Clinicians should consider high-protein supplements as a potential etiology for hyperammonemia, even without liver disease.
Awareness of SHAKE syndrome is crucial for timely diagnosis and management, especially given the widespread use of supplements.