CASE A 73 year old female had been diagnosed as primary biliary cirrhosis and Sjögren's syndrome since the age of 50. With persisting hyperammonemia, the patient was admitted on several occasions for the management of hepatic encephalopathy. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the abdomen showed varices in the splenic hilar region and a splenorenal shunt. A bal...

PURPOSE Mild swelling of astrocytes is proposed as a key event in the pathogenesis of hepatic encephalopathy. Proton MR spectroscopy ((1)H-MR spectroscopy), diffusion-weighted imaging (DWI), and magnetization transfer imaging were performed in patients with alcoholic and nonalcoholic liver cirrhosis and correlated with different clinical stages of hepatic encephalopathy to assess alterations in...

Antibiotics Antibiotic therapy is indicated for treatment of suppurative hepatitis, cholangiohepatitis and hepatic encephalopathy, and prevention of septicemia. The bactericidal function of the hepatic reticuloendothelial (RE) system may be compromised in hepatic disease, especially if hepatic blood flow or oxygen tension is altered, resulting in septicemia. In hepatic bacterial encephalopathy,...

1. Episodic (precipitant-induced) encephalopathy, commonly seen in the hospital setting, where a superimposed event is a key factor. 2. Persistent (chronic) encephalopathy, seen with extensive portal–systemic shunts and after portocaval shunt surgery or placement of transjugular intrahepatic portosystemic shunt (TIPS). 3. Minimal (subclinical) encephalopathy reflects alterations in cognitive fu...

We correlated MR images with histologic findings in two autopsy-proven cases of chronic hepatic encephalopathy. Cortical hyperintensities on T2-weighted images histologically revealed pseudolaminar spongy degeneration in the deep layers of the cerebral cortices and hyperintensities in the cerebral white matters showed tissue rarefaction associated with loss of myelin and axons but without react...

Minimal hepatic encephalopathy (MHE) is the mildest form of spectrum of hepatic encephalopathy (HE). Patients with MHE have no recognizable clinical symptoms of HE but have mild cognitive and psychomotor deficits. The prevalence of MHE is high in patients with cirrhosis of liver and varies between 30% and 84%; it is higher in patients with poor liver function. The diagnostic criteria for MHE ha...

Objective: Hepatic encephalopathy is a cognitive, motor and behavioral disorder caused by the accumulation of liver metabolism products accompanying hepatic failure. The clinical picture appears with metabolites such as ammonia gamma aminobutyric acid. In our study, we aimed to investigate effect blood levels on mortality in patients diagnosed encephalopathy.Material Methods: records who were a...

Hepatic encephalopathy (HE) is a neuropsychiatric disorder that may accompany either acute or chronic liver disease. It is defined as a disturbance of central nervous system function due to hepatic insufficiency and includes a large spectrum of clinical manifestations such as decreased intellectual function, personality disorders, alterations in level of consciousness and neuromuscular dysfunct...

Although severe anemia can theoretically result in anemic hypoxia and can then lead to hypoxic encephalopathy, it is not a primary cause of encephalopathy. More frequently anemia can contribute with other multiple causes of encephalopathy such as infection, metabolic abnormalities, trauma, hepatic dysfunction, hypertension, toxins, etc. We present here an interesting case of recent onset anemia...

Hepatic encephalopathy (HE), the neuropsychiatric presentation of liver disease, is associated with high morbidity and mortality. Reduction of plasma ammonia remains the central therapeutic strategy, but there is a need for newer novel therapies. We discuss current evidence supporting the use of interventions for both the general management of chronic HE and that necessary for more acute and ad...