Encephalopathy & Coma
What is hepatic encephalopathy?
Hepatic encephalopathy (HE) is a disorder of mental activity, neuromuscular function and consciousness that occurs as a result of either chronic or acute liver failure. This complex neuropsychiatric syndrome is primarily caused by metabolic abnormalities. The syndrome may occur spontaneously or be induced by some precipitating factor and may be reversible by improvement in liver function, correction of the precipitating factors or the administration of therapy. However, HE can eventually lead to coma, and may be fatal especially in acute liver failure.
What are the stages of hepatic encephalopathy?
There are four different stages of symptoms of HE. The abnormalities that reflect mental and personality changes are distinguished from those reflecting neuromuscular functions.
In Stage 1, the symptoms include short attention span, nightmares and poor night time sleep with daytime sleepiness, restlessness, depression, aimless wandering, anxiety and irritability.
In Stage 2, the mental and personality changes include obvious drowsiness, obvious personality changes, gross impairment of ability to do mental tasks, slowed response, disobedience, sullenness, disorientation for time and place.
In Stage 3, the symptoms include bizarre behavior, occasional fits of rage, marked confusion, incomprehensible speech, paranoia and anger.
In Stage 4, coma is present and can be either responsive or unresponsive to painful stimuli.