Hepatic encephalopathy

The diagnosis of hepatic encephalopathy is a clinical one, once other causes for confusion or coma have been excluded; no test fully diagnoses or excludes it. Serum ammonia levels are elevated in 90% of people, but not all hyperammonaemia (high ammonia levels in the blood) is associated with encephalopathy.

The efficacy of the blood-brain barrier is compromised in certain pathological states (e.g. tumor, infection, trauma, stroke, hepatic encephalopathy…), and can also be manipulated pharmacologically (e.g. hypertonic mannitol increases the permeability, whereas steroids reduce the penetration of small hydrophilic molecules).

It is important to rule it out for brain death criteria.

Osmotic demyelination syndrome

Central pontine myelinolysis (CPM) over-correcting serum sodium in patients with hepatic encephalopathy.


  • hepatic_encephalopathy.txt
  • Last modified: 2020/09/04 10:15
  • by administrador