Hepatic Encephalopathy

Hepatic encephalopathy is neuropsychiatric syndrome from acute/chronic liver failure or portosystemic shunting, presenting with confusion, asterixis, somnolence, and coma. Treatment: identify/treat precipitant (constipation/infection/variceal bleeding/electrolyte imbalance/drugs); lactulose (acidify gut/ reduce ammonia); rifaximin (nonabsorbable antibiotic); protein intake (do not restrict); nutritional support; treat underlying liver disease; ICU if grade III-IV; liver transplant evaluation; monitor for recurrence; follow-up.

Common Symptoms

Confusion; asterixis; somnolence; coma; by liver failure/shunting

Causes and Pathogenesis

Ammonia/neurotoxin accumulation from liver failure/shunting causes cerebral dysfunction.

Treatment

Lactulose/rifaximin; treat precipitants; nutrition; ICU if severe; transplant eval

Preventive Measures

Treat cirrhosis; avoid sedatives/constipation; monitor ammonia.

Department to Visit

It is recommended to visit the Gastroenterology/Hepatology/Neurology/Critical-care department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.