Definition:
Hepatic encephlopathy is a neuropsychological disorder causing chronic or acute liver failure. The liver failure results in an accumulation of toxic substances in the blood and would affect the brain cells, which healthy livers normally remove. Impairment of mental functioning is the main characteristic of hepatic encephalopathy.
Diagnosis:
Doctors will probe into a patient's medical history and conduct a physical examination to make a diagnosis. A mental status exam will also be conducted as well as blood tests to evaluate the ammonia level.
Treatment:
Treatment includes reduction of protein intake, correction of hypokalemia, administration of lactulose, antibiotics, rifaximin, and benzodiazepine receptor antagonists. Oral administration of magnesium citrate may aid gastrointestinal bleeding.
Symptoms and Signs:
Symptoms of hepatic encephalopathy include flapping tremor (asterixis), decreased level of coconsciousness and possibly trauma, impaired condition, cerebral edema, and possible death.
Early signs include day and night reversal which mean that patients sleep during the day and are awake at night. Impairment in spatial cognition is also presented, wherein patients cannot draw simple shapes such as cubes and stars.
Causes:
Causes of hepatic encephalopathy include potassium deficiency, alkalosis, narcotics, sedatives, hypnotics, drugs containing amino compounds or ammonia, or infections in the liver or body.
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