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QJM Advance Access published online on November 10, 2009
QJM, doi:10.1093/qjmed/hcp152
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© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Current concepts in the assessment and treatment of Hepatic Encephalopathy

W.J. Cash1, P. McConville2, E. McDermott1, P.A. McCormick1, M.E. Callender2 and N.I. McDougall2

From the 1National Liver Transplant Unit, St. Vincent's University Hospital, Dublin, Ireland and 2Liver Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK

Address correspondence to W.J. Cash, MB BCh MRCP, St Vincent's University Hospital, Dublin, Ireland. email: jcash{at}btinternet.com


  Abstract

Hepatic encephalopathy (HE) is defined as a metabolically induced, potentially reversible, functional disturbance of the brain that may occur in acute or chronic liver disease. Standardized nomenclature has been proposed but a standardized approach to the treatment, particularly of persistent, episodic and recurrent encephalopathy associated with liver cirrhosis has not been proposed. This review focuses on the pathogenesis and treatment of HE in patients with cirrhosis. The pathogenesis and treatment of hepatic encephalopathy in fulminant hepatic failure is quite different and is reviewed elsewhere.


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