Hepatic encephalopathy - current considerations

Abstract

Hepatic encephalopathy (EH) is a syndrome involving a series of neuropsychiatric abnormalities in patients with hepatocellular damage and/or portosystemic venous shunts in the absence of other cerebral diseases. It is the late consequence of portal hypertension with a high degree of spontaneous or surgically created portosystemic shunts. The pathogenic substrate is the diffuse disturbance of cerebral metabolism due to insufficient processing or shunting of the liver by intestinal toxic nitric products. The clinical evaluation by psychometric tests may reveal minimal EH for an adequate early management and preservation of the integrity of cerebral functions in patients with cirrhosis.