Have you ever heard of the term hepatic encephalopathy? Maybe now that you are reading this article, one of your friends and relatives in the hospital is in the phase of hepatic encephalopathy. In this article, we intend to provide information about the concept of hepatic encephalopathy and talk about the symptoms and clinical manifestations in people with encephalopathy.

Doctors use the term hepatic encephalopathy when brain function is reduced and impaired due to liver dysfunction.

In fact, hepatic encephalopathy is not a disease in itself, but a secondary disorder that will follow a liver disorder.

The liver plays a key role in clearing toxins from the bloodstream. In some disorders and liver failure, the liver cannot complete detoxification, so we will have the accumulation of toxins in the bloodstream. These toxins reach the brain through the bloodstream and cause brain dysfunction or encephalopathy.

Because the liver disorder has caused this encephalopathy, it is called hepatic encephalopathy.

In the phase of hepatic encephalopathy, the patient first becomes confused, then loses consciousness and eventually goes into a coma.


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Types of hepatic encephalopathy or HE

In one form of classification, HE can be divided into the following two general categories:


  1. Acute hepatic encephalopathy:

Acute hepatic disease occurs in a person with severe liver disease. Doctors say the occurrence of acute hepatic encephalopathy in a person with severe liver disease can be a sign of liver failure.

The following people may develop acute hepatic encephalopathy:

Toxins can cause severe inflammation and liver disorders called toxic hepatitis.

They are the causative agents of toxic hepatitis

It is a very serious condition that often occurs in children and quickly causes cerebral edema and inflammation of the brain and liver.


  1. Chronic hepatic encephalopathy:

This complication occurs in people who have previously had cirrhosis and liver failure. These people should be treated promptly. Chronic hepatic encephalopathy can occur frequently or cause permanent complications such as seizures or spinal cord injuries.

In the following, we will deal with another type of HE classification.

This type of hepatic encephalopathy develops following an acute ALF liver failure.

These people have no previous history of liver disease and suddenly experience a decrease in liver function. This decrease in function progresses over days and weeks. The most common cause of type A encephalopathy is acetaminophen overdose.

And other causes are:

This type causes disorders of blood flow around the liver that interfere with the liver’s detoxification function.

The most common causes of type B HE

Cirrhosis is the last phase of liver dysfunction.

Seventy percent of people with cirrhosis will have HE

Many people with cirrhosis may only experience mild symptoms of hepatic encephalopathy that recur frequently throughout their lives. The most common causes of cirrhosis are:


Stages and symptoms of liver encephalopathy

There are five standard stages for hepatic encephalopathy. At each stage, the symptoms vary in type and severity. There is an increase in the severity of the symptoms in advanced stages. Physicians describe these five stages according to criteria known as West Haven as follows:

Step zero:

Clinical signs will be minimal, for example, to the extent of impaired concentration

Step one:

Step Two:

Moderate clinical signs appear

Step three:

In this phase, the symptoms have intensified.

Step Four:

At this stage, the person has a decreased level of consciousness and will eventually fall into a coma


Why does hepatic encephalopathy occur?

Disorders of liver function will lead to an increase in toxins in the bloodstream. A healthy liver will remove toxins such as nitrogenous toxins and ammonia compounds from the blood.

In the presence of a defective liver, the accumulation of toxins in the blood increases and as the toxins reach the brain, the brain cells become impaired and their function decreases. In the early stages, the manifestations of this decrease and dysfunction of brain cells are low and mild. With gradual progression, both the symptoms become more severe and the symptoms become more severe.

The following factors may provide the conditions for the onset and progression of hepatic encephalopathy, or they may themselves cause symptoms such as hepatic encephalopathy:


Aggravating factors

We emphasize that hepatic encephalopathy will be severely exacerbated despite any of the following conditions:


Symptoms HE

Certainly, the clinical signs and manifestations of hepatic encephalopathy are related to the underlying cause, ie the type of liver disorder, but in general


Symptoms in moderate hepatic encephalopathy:


Symptoms in severe HE:

Failure to seek immediate medical attention will result in coma.

Hepatic encephalopathy is considered as a neurological abnormalities that can be controlled and eliminated with timely treatment. With the improvement of liver function, all symptoms will disappear.

Sometimes hepatic encephalopathy presents only with psychological problems and personality changes.


Complications of hepatic encephalopathy