Hepatic encephalopathy is known as a syndrome characterized by personality variability, weakening of the state of consciousness, which is often found in patients with cirrhosis. Hepatic encephalopathy, which is caused by the passage of portal blood into the systemic circulation, can also be observed in patients with portocavalchant without cirrhosis. Ankara Dr. specializing in hepatic encephalopathy. In this article, in which we discuss the symptoms of hepatic encephalopathy and approaches to its treatment from Meltem Sözen, you will also be able to see which treatments can be applied in the clinical conditions of hepatic encephalopathy.
Contents
What is Encephalopathy?
Encephalopathy, which is used as a general term meaning brain disease, damage or malfunction, is explained by the definitions it is used with. For example, anoxic encephalopathy refers to brain damage due to lack of oxygen, while hepatic encephalopathy refers to brain function disorders due to liver disease.
Ensefal often widespread sightings of disease among the reasons for the lack of oxygen, head trauma, the death of brain cells due to excessive alcohol consumption, liver failure or cancer, the ratio of sugar in the blood is very high, due to the blood brain tumours and may include renal failure are not being cleaned. It is useful to look at the causes and symptoms of hepatic encephalopathy in detail.
What are the Symptoms of Hepatic Encephalopathy?
Clinical Manifestations of Hepatic Encephalopathy
- State of mental disorder,
- Neuromuscular abnormality
- Flapping tremor
- Serious disorders in personality, intelligence and speech
- Sleep disorders & hypersomnia
- Decrease in spontaneous movements & apathy
- Coma
- Speech disorders and slowness
- Uremia
- Respiratory failure
- Severe heart failure
- Deep tendon reflexes
- Hyperventilation and fever rise
- Reversible cortical blindness
How is Encephalopathy Treated?
Since each of the cases of hepatic encephalopathy has individual symptoms, the methods of treatment will also be separate. Therefore, the treatments for hepatic encephalopathy must also differ, depending on the different causes.
- Short-term anoxia ( less than two minutes), on the other hand, with oxygen therapy
- Long-term anoxia with rehabilitation
- Short-term alcohol toxicity with IV fluids
- Chronic liver failure or cirrhosis, on the other hand, can be treated with oral lactulose, antibiotics and a low-protein diet.
- If static encephalopathy is involved, rehabilitation is the last option to prevent further damage.
Treatment of Hepatic Encephalopathy According to the Clinical Picture
Acute Hepatic Encephalopathy
- It will be appropriate to take supportive measures. ( Calories, fluid intake, etc.)
- It is necessary to determine the precipitating factor, and then provide its treatment.
- In the case of GI Bleeding, Endoscopy + Varicose ligation can be performed.
- If there is an infection, Antibiotic therapy should be started
- If there is hypokalemia or alkalosis, diuretics should be discontinued and potassium replacement should be provided.
- In the case of sedatives and tranquilizers, flumazenil and naloxone should be tried.
- If there is azotemia, it is necessary to avoid nephtotoxic agents and adjust the intravascular volume.
- If there is acute hepatic damage, it will be appropriate to avoid hepatotoxic drugs, not to use antivitals and to be included in the transplant list.
Cleansing of the intestines with an enema is provided.
It is aimed to start a protein-free diet.
Antibiotic therapy can be started if appropriate.
Chronic Hepatic Encephalopathy
- Avoiding the administration or use of drugs containing nitrogen
- Ensuring defecation at least twice a day
- To support the use of lactulose or lactylol
- Restricting protein intake to 50 gm per day
- Restoring hepatic perfusion
- In case of worsening of symptoms, it may be necessary to follow the regimen as in an acute coma.
