What causes minimal (covert) hepatic encephalopathy (HE)?

Updated: Apr 04, 2019
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Answer

Answer

Minimal hepatic encephalopathy is most likely the result of hyperammonemia. Elevated ammonia levels are detected in most patients. Similarly, the subtle neurological changes of minimal hepatic encephalopathy can be improved by the administration of lactulose. [75] Minimal hepatic encephalopathy is an important diagnostic consideration in patients with cirrhosis. It is associated with a diminished quality of life, [76] an increased risk of falls, [77] and impaired ability to operate a motor vehicle. [78, 79] For this reason, a number of authors have raised concern that the term "minimal" may trivialize the condition and have proposed that this disease stage be renamed covert encephalopathy. [26]


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