Original Paper

Metabolic Brain Disease

, Volume 25, Issue 1, pp 73-80

Hyponatremic and hepatic encephalopathies: similarities, differences and coexistence

  • Juan CórdobaAffiliated withServei de Medicina Interna-Hepatologia, Hospital Universitari Vall d’HebronDepartament de Medicina, Universitat Autònoma de BarcelonaCIBERehd, Instituto de Salud Carlos III Email author 
  • , Rita García-MartinezAffiliated withServei de Medicina Interna-Hepatologia, Hospital Universitari Vall d’HebronDepartament de Medicina, Universitat Autònoma de Barcelona
  • , Macarena Simón-TaleroAffiliated withServei de Medicina Interna-Hepatologia, Hospital Universitari Vall d’HebronDepartament de Medicina, Universitat Autònoma de Barcelona

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Abstract

Hyponatremic and hepatic encephalopathy are common causes of metabolic encephalopathy that may coexist in patients with cirrhosis. The clinical picture is common to any metabolic encephalopathy and is characterized by a confusional syndrome that may evolve into coma. Chronic mild or minimal manifestations can be seen in both, but motor symptoms are more common in hepatic encephalopathy. Recent advances show that in addition to clinical manifestations both encephalopathies share some pathogenetic mechanisms. Dysfunction of astrocytes, osmotic changes in the brain and brain edema are present in both situations. Recognition of these abnormalities is important to plan therapy. New drugs that affect brain hydration may be useful for both encephalopathies.

Keywords

Metabolic encephalopathy Hepatic encephalopathy Liver failure Cirrhosis complications Human