Encefalopatia epatica

Abstract

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome including neuropsychic and neuromuscular function abnormalities. HE can develop during both chronic or acute hepatic disease resulting from serious hepatocellular impairment and/or porto-systemic shunts. Although HE occurring in chronic liver disease is a reversible condition being related to metabolic disturbances and not to anatomic alterations, it carries a negative prognostic value for patient's survival. HE during acute liver failure is associated with anatomic alterations developing during acute hepatic failure. Those alterations are mainly characterized by cerebral oedema which can eventually lead to irreversible damage and to the death of the patient due to cerebral or cerebellar erniation and cerebral hypoxia. The present review focuses on the pathogenesis, clinical picture, diagnosis and therapy of HE with particular attention to HE developing during chronic liver disease, a quite frequent clinical condition found both in specialized hospitals and in general practice. © Mattioli 1885 Casa Editrice.