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Hepatic encephalopathy
1Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Gastroenterology Report
|May 24, 2017
Summary
Hepatic encephalopathy (HE) is a reversible brain dysfunction in advanced liver disease. Treatment involves addressing causes and using lactulose or rifaximin for overt HE.
Area of Science:
- Hepatology
- Neurology
- Gastroenterology
Background:
- Hepatic encephalopathy (HE) is a reversible brain dysfunction associated with advanced liver disease.
- Its exact pathophysiology remains under investigation, with leading theories involving neurotoxins, altered neurotransmission, and systemic inflammation.
Purpose of the Study:
- To review the pathophysiology, diagnosis, classification, and treatment of hepatic encephalopathy.
- To provide an overview of current understanding and management strategies for HE.
Main Methods:
- Literature review and synthesis of existing research on hepatic encephalopathy.
- Classification of HE based on disease, severity, course, and precipitating factors.
Main Results:
- HE presents with a spectrum of neurological and psychiatric symptoms, ranging from minimal HE detected by psychometric tests to overt HE manifesting as disorientation and coma.
- Diagnosis of overt HE relies on clinical presentation, with no specific tests required beyond clinical studies.
Conclusions:
- Treatment for overt HE includes supportive care, addressing precipitating factors, and administration of lactulose and/or rifaximin.
- Routine treatment for minimal HE is reserved for selected patients.
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