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Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
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Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy

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Hepatic Encephalopathy in Children

Johanna Ascher Bartlett1, Rohit Kohli2

  • 1Department of Gastroenterology, Hepatology and Nutrition at Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 78, Los Angeles, CA, 90027, USA. jascherbartlett@chla.usc.edu.

Indian Journal of Pediatrics
|June 13, 2023
PubMed

Insights

Hepatic encephalopathy (HE) in children involves mental status changes and requires careful assessment. Early detection and management of HE, including reducing ammonia levels, are crucial for preventing serious complications.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Neuroscience

Background:

  • Hepatic encephalopathy (HE) presents with mental status and neuropsychiatric changes in chronic and acute liver disease.
  • Clinical manifestations of HE in children can be subtle, making early diagnosis challenging.
  • Progression of HE symptoms may signal cerebral edema and systemic deterioration.

Purpose of the Study:

  • To highlight the importance of assessing hepatic encephalopathy in pediatric patients.
  • To discuss current and emerging diagnostic methods for HE.
  • To outline current treatment strategies for HE.

Main Methods:

  • Review of clinical manifestations and diagnostic challenges of HE in children.
  • Discussion of established and investigational assessment tools (imaging, EEG, neurobiomarkers).
  • Analysis of current therapeutic interventions for HE.

Main Results:

  • Hyperammonemia can be present in HE, but its level does not correlate with clinical severity.
  • Newer diagnostic modalities are under investigation.
  • Treatment focuses on the underlying liver disease and ammonia reduction.

Conclusions:

  • Prompt recognition and management of HE in children are critical.
  • Multifaceted treatment approaches, including medications and liver support, are employed.
  • Ongoing research aims to improve HE diagnosis and treatment.

Keywords:
CirrhosisEncephalopathyLiver failurePediatrics

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