Knowra Hepatic encephalopathy Hepatic encephalopathy Hepatic encephalopathy is brain dysfunction caused by liver failure or blood bypassing the liver through portosystemic shunts. It ranges from subtle cognitive changes to coma.
Ammonia : A nitrogen-containing compound produced during protein breakdown and normally converted to urea by the liver. Impaired clearance lets ammonia contribute to astrocyte swelling and altered brain function.
West Haven criteria : A clinical grading system that classifies hepatic encephalopathy by changes in consciousness, behavior, and cognitive function. These grades distinguish subtle impairment from disorientation, stupor, and coma.
Cirrhosis : Advanced liver scarring that distorts hepatic structure and impairs liver function. It is a common underlying condition when hepatic encephalopathy develops.
Covert hepatic encephalopathy : Hepatic encephalopathy encompassing minimal disease and mild cognitive or behavioral changes not evident as overt disorientation. It contrasts with overt disease, which produces clinically apparent altered mental status.
Astrocyte : A star-shaped glial cell that supports neurons, regulates the brain environment, and participates in the blood–brain barrier. Ammonia-related glutamine accumulation can disrupt astrocyte function and promote swelling.
Psychometric Hepatic Encephalopathy Score : A battery of paper-and-pencil tests used to detect minimal hepatic encephalopathy. It can reveal cognitive deficits that routine examination misses.
Acute liver failure : A rapid loss of liver function in a person without preexisting advanced liver disease. It can cause severe encephalopathy over a short period.
Overt hepatic encephalopathy : Clinically apparent hepatic encephalopathy marked by disorientation, abnormal behavior, reduced consciousness, or coma. This form is distinguished from covert impairment by observable changes in mental status.
Portosystemic shunt : A blood vessel pathway that diverts portal blood into the systemic circulation, bypassing the liver. Bypassing hepatic detoxification can produce encephalopathy even without advanced liver failure.
Lactulose : A nonabsorbable sugar used to treat constipation and reduce intestinal ammonia absorption. It is a standard first-line treatment that lowers intestinal ammonia burden.
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