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Hepatic Encephalopathy

Confusion, mental dullness, drowsiness and even coma caused by liver failure.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases and National Library of Medicine)

About Hepatic Encephalopathy

A failing liver cannot remove toxins from the blood, so they eventually accumulate in the brain. The buildup of toxins in the brain is called hepatic encephalopathy. This condition can decrease mental function and cause stupor and even coma. Stupor is an unconscious, sleeplike state from which a person can only be aroused briefly by a strong stimulus, such as a sharp pain. Coma is an unconscious, sleeplike state from which a person cannot be aroused. Signs of decreased mental function include

  • confusion
  • personality changes
  • memory loss
  • trouble concentrating
  • a change in sleep habits

NIH - National Institute of Diabetes and Digestive and Kidney Diseases

What works? Research summarized

Evidence reviews

Portosystemic shunts compared with sclerotherapy/banding lowers variceal rebleeding, but increases hepatic encephalopathy

A third of deaths from cirrhosis are due to variceal bleeding. Randomised clinical trials have compared three types of portosystemic shunting separately against endoscopic therapy. The shunts included in these trials have been total portocaval shunts, distal splenorenal shunts, and transjugular intrahepatic portocaval shunts. The authors found that when compared to endoscopic therapy all three types of shunt lowered the rate of rebleeding at the cost of a higher incidence of hepatic encephalopathy, without any statistically significant difference in survival.

Flumazenil causes short‐term improvement of hepatic encephalopathy in patients with chronic liver disease

Hepatic encephalopathy refers to changes in mental state, ranging from minor signs of altered brain function to deep coma occurring in patients with liver failure. Hepatic encephalopathy may be caused by an activation of a receptor‐complex in the brain. Flumazenil, which inhibits this receptor‐complex, might ameliorate the symptoms. This review found that flumazenil leads to a short‐term improvement of hepatic encephalopathy in some patients with chronic liver disease and a highly favourable prognosis.

Dopamine agents for hepatic encephalopathy

Hepatic encephalopathy is a serious complication of severe liver disease. The disease is often fluctuating with a wide spectrum of symptoms ranging from minor, not readily discernible signs to deep coma. Symptoms often develop in connection to stress related to infection, dehydration, obstipation, or gastrointestinal bleeding. The exact underlying mechanisms behind the disease development are not known. Experimental studies suggest that the mental changes seen in hepatic encephalopathy reflect changes in neurotransmitters in the brain.

See all (103)

Summaries for consumers

Portosystemic shunts compared with sclerotherapy/banding lowers variceal rebleeding, but increases hepatic encephalopathy

A third of deaths from cirrhosis are due to variceal bleeding. Randomised clinical trials have compared three types of portosystemic shunting separately against endoscopic therapy. The shunts included in these trials have been total portocaval shunts, distal splenorenal shunts, and transjugular intrahepatic portocaval shunts. The authors found that when compared to endoscopic therapy all three types of shunt lowered the rate of rebleeding at the cost of a higher incidence of hepatic encephalopathy, without any statistically significant difference in survival.

Flumazenil causes short‐term improvement of hepatic encephalopathy in patients with chronic liver disease

Hepatic encephalopathy refers to changes in mental state, ranging from minor signs of altered brain function to deep coma occurring in patients with liver failure. Hepatic encephalopathy may be caused by an activation of a receptor‐complex in the brain. Flumazenil, which inhibits this receptor‐complex, might ameliorate the symptoms. This review found that flumazenil leads to a short‐term improvement of hepatic encephalopathy in some patients with chronic liver disease and a highly favourable prognosis.

Dopamine agents for hepatic encephalopathy

Hepatic encephalopathy is a serious complication of severe liver disease. The disease is often fluctuating with a wide spectrum of symptoms ranging from minor, not readily discernible signs to deep coma. Symptoms often develop in connection to stress related to infection, dehydration, obstipation, or gastrointestinal bleeding. The exact underlying mechanisms behind the disease development are not known. Experimental studies suggest that the mental changes seen in hepatic encephalopathy reflect changes in neurotransmitters in the brain.

See all (14)

More about Hepatic Encephalopathy

Photo of an adult

Also called: Hepatocerebral encephalopathy, Gaustad's syndrome, Portal systemic encephalopathy, Transient hepatargy syndrome, Portal-systemic encephalopathy, HE

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