Hepatic encephalopathy (HE) is a condition characterized by brain dysfunction resulting from acute and/or chronic liver dysfunction. The term “hepatic” refers to the liver, while “encephalopathy” indicates brain-related issues.
Symptoms of Hepatic Encephalopathy:
HE can manifest in various ways. There may be no symptoms in early and mild disease.
Mood and personality: Changes in behavior and impulse control.
Memory and concentration: Altered thinking and confusion.
Consciousness and sleep patterns: Disorientation and erratic sleep.
Motor functions and coordination: Abnormal movements.
Autonomy: Ability to care for oneself.
Symptoms may vary in severity and can occur suddenly or gradually.
Causes:
HE is thought to arise from chemicals that pass into the brain. These chemicals are usually filtered by the liver.
Grading System:
The West Haven Criteria grades HE symptoms on a scale of 0 to 4:
Minimal Hepatic Encephalopathy (MHE) (Stages 0-1): Subtle changes in memory, concentration, and reaction time.
Overt Hepatic Encephalopathy (Stages 2-4): More noticeable symptoms, including confusion and altered consciousness.
Complications and Risk:
If left untreated, HE can lead to serious complications.
The severity of HE may also reflect the severity of liver disease.
Prevention and Management (not limited to the following):
Avoid/minimize/treat other liver risk factors: Alcohol, viral hepatitis, metabolic liver disease, etc.
Avoid certain medications: eg Benzodiazepines and barbiturates.
Vaccination against viral hepatitis
Exercise and maintain a healthy weight
Diet
Medication
Liver transplantation: may be considered for severe cases.