Hepatic Encephalopathy

  • Gerald Y. Minuk
Part of the Topics in Gastroenterology book series (TGEN)


Hepatic encephalopathy is a complex neurological disorder associated with advanced liver disease of either acute or chronic nature. The etiology of this disorder has confounded investigators since it was first described by Hippocrates in 460–370 B.C. One reason why the pathogenesis has remained so elusive for so long is that our understanding of normal consciousness remains relatively incomplete. Another is that much of the research past and present has been carried out in animal models of acute or, less commonly, chronic liver disease and whether the results of these studies can be extrapolated to humans remains to be determined. Finally, there is tremendous compartmentation and functional heterogeneity throughout the brain and the sophisticated techniques required to study specific regions or, more precisely, the specific synapses responsible for disturbed levels of consciousness have yet to be developed. Despite these limitations, sufficient experimental data are available to state that normal brain function in humans is dependent on at least three important factors: (1) adequate oxygenation, (2) adequate glucose or nutritional support, and (3) intact neurotransmitter systems. Thus, disturbances in any one of these three areas could conceivably result in an alteration in normal consciousness.


Hepatic Encephalopathy Aromatic Amino Acid Advanced Liver Disease Hepatic Coma Portal Systemic Encephalopathy 
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Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Gerald Y. Minuk
    • 1
  1. 1.Department of MedicineUniversity of ManitobaWinnipegCanada

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