[Pathogenesis and treatment of hepatic encephalopathy]

Cirrhotic patients with hepatic encephalopathy show a variety of neuropsychiatric abnormalities. The pathogenesis appears to be ascribable to an increase in gut-derived neurotoxic substances and to functional alteration in inhibitory and excitatory neurotransmission in the brain. On the basis of the potential pathogenesis, therapies are designed by reducing the production and absorption of gut-derived neurotoxins and/or by modifying the balance of central neurotransmission. In this review, the current concept of the pathogenesis and treatment of hepatic encephalopathy is described.