Definition and Changes in Nomenclature of Hepatic Encephalopathy
Hepatic encephalopathy is by definition a brain dysfunction caused by liver insufficiency and/or PSS; it manifests as a wide spectrum of neurological or psychiatric abnormalities ranging from subclinical alterations to coma. It is related to brain dysfunction from a combination of ammonia, endotoxins, and other neurotoxins with the end result being neuro-inflammation. Given the vast spectrum of manifestations, the nomenclature is detailed with multiple components to address aspects such as etiology, severity, temporality, and precipitating factor. From a clinical perspective it is important to understand each aspect in order to determine the etiology of the episode and to plan for prevention of recurrence. A strong initial workup based on the nomenclature will ensure a more successful outcome for the patient in the long run.
KeywordsOvert hepatic encephalopathy Covert hepatic encephalopathy West Haven grade
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