Hepatic encephalopathy is a brain disorder caused by neurotoxins your liver fails to eliminate because of reduced function. Normally, a healthy liver converts many blood circulating toxins into harmless substances for removal. With a dysfunctional liver this protective process breaks down, allowing for the accumulation of certain neurotoxins that can penetrate your brain’s barrier, e.g. ammonia and manganese. Upon entry, these poisons can damage brain cells causing various impairments.
A primary reason toxins remain in the blood is because of shunting, which means some blood gets diverted around your liver. As a result, this bypassing blood has not been detoxified. This occurs when the flow of blood through your liver is inadequate to meet circulatory demand. Cirrhosis and hepatitis are two liver disorders that can cause a decline in function to a point where excessive shunting may occur. Yet, other forms of liver damage can lead to hepatic encephalopathy as well.
In addition, hepatic encephalopathy can be triggered by other health conditions, like:
- hypoxia
- dehydration
- kidney problems
- gastrointestinal bleeding
- excessive consumption of protein
- electrolyte imbalance caused by hypokalemia, paracentesis, diuretics
- drugs suppressing central nervous system ~ barbiturates, benzodiazepines
Typically, hepatic encephalopathy causes a gradual worsening of brain function. The symptoms of this brain disorder may be subtle and hardly noticeable at first, including mild confusion, forgetfulness, fogginess, confusion, lack of concentration and poor judgment. As it progresses, more severe changes begin to occur, for instance agitation, disorientation, inappropriate behavior altered personality and slurred speech. Ultimately, there’s a possibility of becoming unconscious or falling into a coma.