Hepatic encephalopathy historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Hepatic encephalopathy was first discovered by G.B. Morgagni, an italian anatomist, in the 18th century who described a case of hepatic encephalopathy. Friedrich Theodor Von Frerichs, in the 19th century clearly reported the existence of episodes of delirium, somnolence and coma in liver disease in his famous treatise on liver disease. In 1954, Dame Sheila Patricia Violet Sherlock and her disciples in London gave a detailed description of the clinical findings, the pathophysiology and treatment of hepatic encephalopathy. For the first time, she confirmed the role of hyperammonaemia in the pathophysiology of the hepatic encephalopathy and the role of gut microbes which could be modulated by antibiotics to revert coma.

Historical Perspective

Discovery

• In 18th century, G.B. Morgagni, an italian anatomist, was the first to discover and describe a case of hepatic encephalopathy.
• In the 19th century, Friedrich Theodor Von Frerichs for the first time reported the existence of episodes of delirium, somnolence and coma in liver disease in his famous treatise on liver disease.
• In 1954, Dame Sheila Patricia Violet Sherlock and her disciples in London gave a deatiled description of the clinical findings, the pathophysiology and treatment of hepatic encephalopathy.
• For the first time, she also confirmed the role of hyperammonaemia in the pathophysiology of the hepatic encephalopathy and the role of gut microbes, that could be modulated by antibiotics to revert coma.

Landmark Events in the Development of Treatment Strategies

• In 1954, Dame Sheila Patricia Violet Sherlock and her disciples published a detailed description of the treatment of hepatic encephalopathy.