Hepatic encephalopathy

Abstract

Hepatic encephalopathy (HE) reflects a spectrum of neuropsychiatric abnormalities seen in patients with liver dysfunction after exclusion of other known brain disease [1]. HE is primarily divided into two components: overt HE (OHE) and minimal HE (MHE). OHE is the specific type of HE that can be diagnosed clinically through a constellation of signs and symptoms while MHE cannot be diagnosed clinically. It has been estimated that OHE is present in 30-45% of patients with cirrhosis with an annual risk of development in 20% of patient with cirrhosis [2]. There is a uniformly poor survival after development of OHE. MHE is manifested by impairment in specialized testing and is considered by most to be a pre-clinical stage of OHE [1]. MHE has been diagnosed in up to 60-80% of patients with cirrhosis and is associated with increased progression to OHE, poor quality of life, and a high risk of traffic violations and accidents [3]. © 2010 Springer Science+Business Media, LLC.