Hepatic Encephalopathy

Excerpt

Hepatic encephalopathy (HE) is a reversible syndrome observed in patients with advanced liver dysfunction. The syndrome is characterized by a spectrum of neuropsychiatric abnormalities resulting from the accumulation of neurotoxic substances in the bloodstream (and ultimately in the brain). Symptoms typically include confusion, personality changes, disorientation, and a depressed level of consciousness. The earliest stage is often characterized by an inverted sleep-wake pattern wherein patients are found to be sleeping during the day and awake throughout the night. Throughout the intermediate stages, patients tend to experience worsening levels of confusion, lethargy, and personality changes. In the advanced stages, hepatic encephalopathy may eventually lead to coma (e.g., hepatic coma or coma hepaticum) and ultimately to death.