What is liver encephalopathy (hepatic encephalopathy)?
Liver encephalopathy refers to the changes in the brain that occur in patients with advanced acute or chronic liver disease. If liver cells are damaged, certain substances that are normally cleansed from the blood by the healthy liver are not removed (ammonia mainly, and other toxins). A patient with chronic hepatic encephalopathy may develop progressive loss of
memory, disorientation, untidiness, and muscular tremors, leading to a form of chronic dementia.
Hepatic encephalopathy is characterized by personality changes, intellectual impairment, and a depressed level of consciousness. An important prerequisite for the syndrome is diversion of portal blood into the systemic circulation through portosystemic collateral vessels. Indeed, hepatic encephalopathy may develop in patients without cirrhosis who have undergone portocaval shunt surgery. The development of hepatic encephalopathy is explained, to some extent, by the effect of neurotoxic substances, which occurs in the setting of cirrhosis and portal hypertension.
Liver encephalopathy is a potentially life-threatening disease in which toxic substances accumulate in the blood. Also known as hepatic encephalopathy or hepatic coma, this condition can cause confusion, disorientation, abnormal neurological signs, loss of consciousness, and death. A normally functioning liver metabolizes and detoxifies substances formed in the body during the digestive process. Impaired liver function allows substances like ammonia (formed when the body digests protein), some fatty acids, phenol, and mercaptans to escape into the bloodstream. From there, they may penetrate the blood-brain barrier, affect the central nervous system (CNS), and lead to hepatic coma. Hepatic coma is most common in patients with chronic liver disease. It occurs in 50-70% of all those with cirrhosis.