Therapy of hepatic encephalopathy

Abstract

Hepatic encephalopathy is a clinical syndrome which appears in the course of hepatic failure. It is due to porto-caval shunts. The major symptoms of hepatic encephalopathy are alterations of intellectual functions, changes of personality and an impairment of neuromuscular functions. The morphological basis of all these changes are a cerebral atrophy, partial cortico-medullary necrosis and the occurrence of macroglial cells. Pathogenetically either an augmented influx of toxic substances from the gut or an increased production of false neurotransmitters might be responsible. Therapeutically restriction of protein intake, sterilisation of the gut and application of branched-chain amino acids or their keto analogs are the major steps for an improvement of the disease.