Clinical overview
Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome exhibiting several symptoms:
- Confusion or amnesia
- Euphoria or depression
- Lack of attention or inability to perform mental tasks
- Irritability, changes in personality
- Altered circadian rhythms, sleep/wake cycle
- Tremors, lack of coordination, abnormal reflexes
- Sleepiness, lethargy
- Disorientation
- Coma
Causes
HE is seen in patients with liver disease/failure/dysfunction. Its evolution is described in 4 stages, and it may develop acutely (over hours or days) or chronically (over months or years):
- Intoxication (hepatotoxines, acetaminophen)
- Viral hepatitis
- urea cycle enzymes deficiency
- cirrhosis
- portal hypertension
Oxidative stress