Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles.

Abstract:

:In general, hepatic encephalopathy (HE) is defined as a brain dysfunction caused by liver insufficiency and/or portal-systemic blood shunting. This article relates to the so-called type C HE: that is, HE in patients with liver cirrhosis. It manifests as a wide spectrum of neurological or psychiatric abnormalities, ranging from subclinical alterations, detectable only by neuropsychological or neurophysiological assessment, to coma. Several scales have been developed for grading the extent of HE. The most often used is the West Haven criteria (WHC), which differentiate between four grades of clinically overt HE. Patients with liver cirrhosis without clinically overt symptoms of HE but neuropsychological or neurophysiological findings indicating brain dysfunction are considered to have minimal hepatic encephalopathy (MHE). For simplification, some experts suggest differentiating between covert HE (MHE plus grade I HE according to WHC) and overt HE (WHC grades II-IV). Diagnosis of both MHE and overt HE is hampered by the fact that none of the symptoms of HE or the findings in the various diagnostic measures applied are specific. Thus, a diagnosis of HE or MHE can only be made after exclusion of other possible causes of brain dysfunction.

journal_name

Drugs

journal_title

Drugs

authors

Weissenborn K

doi

10.1007/s40265-018-1018-z

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

5-9

issue

Suppl 1

eissn

0012-6667

issn

1179-1950

pii

10.1007/s40265-018-1018-z

journal_volume

79

pub_type

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