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(Encephalopathy, Hepatic; Portal-Systemic Encephalopathy; Encephalopathy, Portal-Systemic)
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- Changes in behavior and personality
- Shortened attention span
- Depression or anxiety
- Difficulty sleeping
- Slurred speech
- Uncontrolled movements, particularly a flapping tremor of the hands
- Loss of consciousness
- Liver function tests
- Kidney function tests
- Imaging tests of the liver
Hospitalization and Emergency Care
- Neutralize toxins in the intestine such as ammonia
- Remove blood from the intestines
- Reduce ammonia production by intestinal bacteria
- Reduce the amount of ammonia producing bacteria
- Treat the condition that started the encephalopathy
- Reduce recurrence
- Get early treatment for liver problems.
- If you have a disease such as cirrhosis, see your doctor regularly.
- Follow your doctor's instructions regarding medication. Avoid overdosing.
- Avoid being exposed to poisons or toxins.
- Avoid excessive use of alcohol.
- Do not use IV drugs.
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
Canadian Liver Foundation http://www.liver.ca
Health Canada http://www.hc-sc.gc.ca
Bernuau J. Acute liver failure: avoidance of deleterious co-factors and early specific medical therapy for the liver are better than late intensive care for the brain (review). J Hepatol. 2004;41:152-155.
Butterworth RF. Role of circulating neurotoxins in the pathogenesis of hepatic encephalopathy: potential for improvement following their removal by liver assist devices. Liver Int. 2003;23(suppl 3):5-9. Review.
Hepatic encephalopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 18, 2014. Accessed March 5, 2014.
Highleyman L. Hepatitis C. HCV Advocate website. Available at: http://www.hcvadvocate.org/hepatitis/hepC/hepatic%5Fencephalopathy.html. Published December 2002. Accessed February 17, 2014.
Juretschke L. Kernicterus: still a concern. Neonatal Netw. 2005;24:7-9.
Lizardi-Cervera J, Almeda P, Guevara L, et al. Hepatic encephalopathy: a review. Ann Hepatol. 2003;2:122-130. Review.
Toftengi F, Larsen F. Management of patients with fulminant hepatic failure and brain edema. Metab Brain Dis. 2004;19:207-214.
4/2/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA approves new use of Xifaxan for patients with liver disease. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm206104.htm. Published March 24, 2010. Accessed February 17, 2014.
- Reviewer: Rimas Lukas, MD
- Review Date: 02/2014
- Update Date: 03/05/2014