Causes of Hepatic Encephalopathy

In this article, we will discuss various Causes of Hepatic Encephalopathy. So, let’s get started.

Acute hepatic encephalopathy is a clinical syndrome of neuropsychiatric manifestations developing within a period of 8 weeks in a patient with acute fulminant hepatitis as a result of massive acute hepatocellular necrosis without any evidence of previous liver disease. Chronic hepatic encephalopathy develops between 8 weeks and 6 months after the onset of acute liver disease. Acute on chronic liver failure refers to acute deterioration of liver function in a person with pre-existing liver disease. This is due to entry of nitrogenous products and gut derived neurotoxins in the circulation and the brain. These nitrogenous products and neurotoxins normally originate in the intestine and are inactivated and metabolized in the liver. In hepatic failure, they bypass the diseased liver and reach the CNS through circulation leading to encephalopathy.

Causes

  • Infection: Viral hepatitis (B and D), yellow fever, leptospirosis
  • Hepatotoxic drugs: Anaesthetics (halothane), NSAIDs, acetaminophen overdose, antitubercular drugs, antiepileptics, etc.
  • Vascular: Hepatic vein thrombosis (Budd-Chiari syndrome), veno-occlusive disease.
  • Poisons: Carbon tetrachloride, poisonous fungi (amantia phalloides), phosphorus.
  • Miscellaneous: Wilson’s disease, Reye’s syndrome, fatty liver of pregnancy, autoimmune hepatitis, etc.
  • Chronic hepatitis or cirrhosis due to any cause such as alcoholism, etc.
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