Hepatic encephalopathy

The liver performs the function of the filter in the body, clearing it of toxins and ammonia. With persistent abnormalities of its functioning, hepatic encephalopathy develops-a syndrome of neuropsychic disorder associated with brain poisoning with harmful substances.

Hepatic encephalopathy - causes

Among the main factors provoking the syndrome under consideration, the most common are:

• viral hepatitis (type B, C, rarely - D, A and E);
• infectious diseases (mononucleosis, yellow fever, leptospirosis);
• chronic liver damage due to alcohol abuse;
• portocaval shunting;
• Badda-Chiari syndrome;
• drug-induced hepatitis;
• poisoning with toxic chemicals;
• fatty degeneration of the liver;
• Wilson-Konovalov's disease .

Hepatic encephalopathy - symptoms

To date, it is common to distinguish the symptoms of the disease in question, depending on the severity of brain poisoning with toxins.

Signs of hepatic encephalopathy according to the stage of the disease:

1. Zero stage. Characterized by the absence of any symptoms, sometimes there may be disturbances in the behavior and reaction of the patient in extreme situations;
2. The first stage. Is manifested in insomnia or other problems with sleep. It becomes difficult for a person to concentrate, there is a sharp decline in efficiency and attention. Over time, emotional instability is noted in the form of irritability, unreasonable anxiety, aggression, depression ;
3. The second stage. In this case, there are violations of speech, motor functions. The patient is apathetic, episodically aggressive, sometimes in a state of delirium, commits acts that are meaningless. There is disorientation in space and time, dysgraphia, tremor;
4. The third stage. This stage is characterized by an increased tone of all the muscles of the body. In addition, there is severe drowsiness, stupor, marked tremor and impaired motor activity;
5. The fourth stage is acute hepatic encephalopathy. Reactions to light and pain are absent, the brain's work slows down with simultaneous attenuation of reflexes, and a hepatic coma sets in.

Hepatic encephalopathy - diagnosis

The diagnosis is made on the basis of the results of a two-stage study. Initially, an extensive laboratory analysis of the patient's blood is conducted, where special attention should be paid to the white blood cell count, erythrocyte sedimentation rate, bilirubin indices and concentration of ammonium compounds. At the same time, it is required to study the gas composition of the blood. Then electroencephalography is performed, which allows to determine changes in the liver, as well as a biopsy of the injured organ.

Treatment of hepatic encephalopathy

Disease therapy consists of eliminating the causes that led to the development of insufficiency, intoxication of the body, reducing the amount of ammonia and other metabolic substances in the blood. In rare cases, antibiotics and corticosteroids are used for relief of the inflammatory process. Very important is the diet in hepatic encephalopathy. It is necessary to limit the consumption of food containing proteins as much as possible, and increase the amount of carbohydrates in the diet. Instead of the usual sugar it is necessary to use synthetic - lactulose. It helps to normalize the intestinal microflora, remove toxins from the body and reduce the intensity of absorption of ammonia.

In the late, fourth stage of hepatic encephalopathy, emergency care should be provided, during which a repeated rinsing of the intestine is performed, glucocorticosteroids and antibiotics are injected intravenously.