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This condition is temporary or permanent damage to the brain. The most common cause is an illness or condition that affects the liver.
Toxins build up in the bloodstream because the liver is not working normally.
Causes
Poisoning
Diseases (eg, :: cirrhosis , :: hepatitis , :: diabetes , :: heart disease , :: renal failure )
Medical conditions that cause blood circulation to bypass the liver
Risk Factors
If you have liver problems, the risk of metabolic encephalopathy is increased by:
The following toxic overdoses can also increase your risk of the condition:
:: Alcohol intoxication
Sedative-hypnotic overdose
:: Lead poisoning
:: Carbon monoxide poisoning
Symptoms
Symptoms include:
Confusion or agitation
Changes in behavior and personality
Forgetfulness
Disorientation
:: Insomnia
Muscle stiffness or rigidity
:: Tremor (particularly a flapping tremor of the hands)
Difficulty speaking
Asterixis (rapid momentary loss of tone in the muscles)
Uncontrollable movements or :: seizures (rare)
Stupor or :: coma
These problems can develop quickly. They may resolve when the condition is reversed. However, prompt treatment is needed before a
coma occurs.
Diagnosis
This condition is very serious. It can quickly become an emergency. You will need to be hospitalized. Doctors will do an exam to
assess your neurological condition.
Blood tests—usually show high blood ammonia levels and other abnormalities related to the failing liver
:: Electroencephalogram (EEG)—may be used to determine how the brain has been affected
Imaging studies of the brain ( :: CT scan or :: MRI )—may be done to evaluate other causes
Treatment
Hospitalization and Emergency Care
In the hospital, the staff will treat the problems that caused the condition. They will try to remove or neutralize toxins that have built
up in the bloodstream. The goal is to reverse the underlying condition. But, brain injury can still occur. In some cases, brain injury is
permanent.
Medications
Neutralize toxins
Treat the condition
Reduce recurrence
Dietary Restrictions
You may need to eat a :: low-protein diet to help lower blood ammonia levels. (The body creates ammonia when it metabolizes and
uses protein.) You may have other changes in your diet.
Tube feeding and life support may be needed, especially in the case of coma.
Transplantation