Hepatic Encephalopathy (Portosystemic Encephalopathy)


Epidemiology


Etiologic Precipitants

Dehydration/Hypovolemia (see Hypovolemic Shock, [[Hypovolemic Shock]])

Increased Ammonia Synthesis

Portosystemic Shunt

Vascular Occlusion

Drugs/Toxins

Other


Physiology

Role of the Neurotoxin Ammonia

Role of the Neurotoxin Oxindole

Impairment of Neurotransmission

Other Potential Mechanisms


Diagnosis


Clinical Manifestations

Clinical Staging

Neurologic Manifestations

Other Manifestations


Treatment

Supportive Measures

Dietary Management

Haloperidol (Haldol) (see Haloperidol, [[Haloperidol]])

Pharmacologic Therapy to Lower Blood Ammonia Level

Embolization of Large Spontaneous Portosystemic Shunts

Other Potential Therapies


Prognosis


References