Hepatic encephalopathy

Abstract

Hepatic encephalopathy (HE) is a metabolically-induced, usually reversible neuropsychiatric syndrome that results in significant morbidity and mortality. The incidence is unknown, but it is estimated that most individuals with cirrhosis develop some degree of HE, and advanced age is a risk factor. Cognitive, behavioral, and motor dysfunction are the characteristic features, although the pattern and severity differ among grades. Neuropsychologists are most likely to encounter HE in the context of liver transplant evaluations. The current chapter reviews the classification and pathogenesis of HE, diagnosis and treatment considerations, and also provides a clinical case example and reviews practical issues that will arise for neuropsychologists involved in the care of patietns with HE.