Hepatic encephalopathy

Hepatic encephalopathy (hepatocerebral syndrome) is a complex of neurological and psychiatric disorders that occurs in patients with chronic liver diseases, with portocaval anastomosis.

Etiology, pathogenesis. The cause of encephalopathy is toxic nitrogenous compounds, resulting from a violation of liver function in the blood and brain. Morphological measurements in the brain are similar to those found in hepatocerebral dystrophy.

Symptoms, course. Progressive dementia and subcortical disorders (tremor, rigidity, bradykinesia). To this can attach cerebellar and pyramidal signs. In the case of a violation of diet (the intake of large quantities of animal protein) there is a sharp aggravation of mental disorders, "episodic stupor", lasting for several days and sometimes turning into a hepatic coma. Unlike hepatocerebral dystrophy, the described symptom complex occurs in patients with obvious liver pathology, with no changes in the copper exchange and the Kaiser-Fleischer ring.

Treatment. A strict diet, with portocaval anastomosis, meat and fish are excluded; Recommended L-DOPA, levulose, leucine.

Forecast. The disease is slowly progressing. Patients die of hepatic coma