What is hepatic encephalopathy (HE)?

Updated: May 18, 2020
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Answer

Answer

Hepatic encephalopathy is a syndrome usually observed in patients with cirrhosis. Hepatic encephalopathy is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, after exclusion of brain disease. [1, 2, 3] Hepatic encephalopathy is characterized by personality changes, intellectual impairment, and a depressed level of consciousness. [4] An important prerequisite for the syndrome is diversion of portal blood into the systemic circulation through portosystemic collateral vessels. [5] Hepatic encephalopathy is also described in patients without cirrhosis with either spontaneous [6] or surgically created portosystemic shunts. The development of hepatic encephalopathy is explained, to some extent, by the effect of neurotoxic substances, which occurs in the setting of cirrhosis and portal hypertension.


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