Hepatic Encephalopathy

Hepatic Encephalopathy

Hepatic encephalopathy (HE) is a serious but potentially reversible neurological disorder that can occur in patients with cirrhosis of any etiology or acute liver failure. It comprises a spectrum of neuropsychiatric abnormalities and motor disturbances that are associated with varying degrees of disability and poor health-related quality of life. Depending on the stage of the disease, neurological signs and symptoms can range from minimal disorientation to overt motor dysfunction and impaired consciousness that can progress to coma and death if untreated.1 HE is believed to occur when the brain is exposed to gut-derived toxins such as ammonia that are normally removed from the blood by a healthy liver. 1,2

Current epidemiological data suggest that there are approximately one million patients in the US with cirrhosis, of whom an estimated 140,000 have overt HE.3,4 There are no therapies currently FDA-approved for the treatment of HE.

  1. Keeffe, E. Current concepts in the management of liver disease. Semin Liver Dis 2007;27(suppl 2):1-2
  2. Mullen, K, Ferenci P, Bass N, et al. An algorithm for the management of hepatic encephalopathy. Semin Liver Dis 2007;27(suppl 2):32-48.
  3. Dufour MC. Chronic liver disease and cirrhosis. In digestive diseases in the United States: epidemiology and impact. JE Everhart, Editor, 1994; NIH publication No. 94-1447:615-646.
  4. Bell BP, Manos MM, Zaman A, et al. The epidemiology of newly diagnosed chronic liver disease in gastroenterology practices in the United States: results from population-based surveillance. Am J Gastroenterol 2008; 103:2727-2735.
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