Encephalopathy: Difference between revisions

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   Image          = Encephalopathy 001.jpg|
   Caption        = Binswangers Subcortical Encephalopathy: Gross fixed tissue horizontal section cerebral hemispheres at level of genu internal capsule <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
   Caption        = Binswangers Subcortical Encephalopathy: Gross fixed tissue horizontal section cerebral hemispheres at level of genu internal capsule <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
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==Overview==
{{Encephalopathy}}
'''Encephalopathy''' literally means [[disease]] of the [[brain]]. It is a brain malfunction in the face of systemic metabolic derangements due to cardiopulmonary, mitochondrial, renal, hepatic or endocrine disease. In medical jargon it can refer to a wide variety of degenerative brain disorders with very different etiologies, prognoses and implications. For example, [[prion]] diseases, all of which cause [[Transmissible spongiform encephalopathy|transmissible spongiform encephalopathies]], are nearly always fatal and have an infectious origin, but other encephalopathies are reversible and can be caused by deficiency, toxins, and several other causes.
 
{{CMG}} ; {{AE}} {{ADI}}
 
== [[Encephalopathy overview|Overview]] ==


==Classification==
== [[Encephalopathy classification|Classification]] ==
There are many types of encephalopathy.  Some examples include:


* [[MELAS|Mitochondrial encephalopathy]] - Metabolic disorder caused by dysfunction of mitochondrial DNA. Can affect many body systems, particularly the brain and nervous system.
== [[Encephalopathy pathophysiology|Pathophysiology]] ==
* [[Glycine encephalopathy]] - A pediatric metabolic disorder
* [[Hepatic encephalopathy]] - Arising from advanced cirrhosis of the liver
* [[Hypoxic encephalopathy]] - Permanent or transitory encephalopathy arising from severely reduced oxygen delivery to the brain
* [[Static encephalopathy]] - Unchanging, or permanent, brain damage
* [[Uremic encephalopathy]] - Arising from high levels of toxins normally cleared by the kidneys -- rare where dialysis is readily available
* [[Wernicke's encephalopathy]] - Arising from thiamine deficiency, usually in the setting of alcoholism
* [[Hashimoto's encephalopathy]] - Arising from an auto-immune disorder
* [[Hypertensive encephalopathy]] - Arising from acutely increased blood pressure
* [[Toxic]]-[[Metabolic]] [[encephalopathy]] - A catch-all for brain dysfunction caused by infection, organ failure, or intoxication.
* [[Transmissible spongiform encephalopathy]] - A collection of diseases all caused by prions, and characterized by "spongy" brain tissue (riddled with holes), impaired locomotion or coordination, and a high fatality rate. Includes [[bovine spongiform encephalopathy]] (mad cow disease), [[scrapie]], and [[Kuru (disease)|kuru]] among others.


==Causes==
== [[Encephalopathy causes|Causes]] ==
Encephalopathy alters brain function and/or structure.It may be caused by an infectious agent ([[bacterium|bacteria]], [[virus]], or [[prion]]), [[metabolism|metabolic]] or [[mitochondrion|mitochondrial]] dysfunction, [[brain tumor]] or increased [[intracranial pressure]], prolonged exposure to toxins (including solvents, drugs, [[alcohol]], paints, industrial chemicals, and certain metals), radiation, chronic progressive trauma, poor nutrition, or lack of [[oxygen]] or blood flow to the brain. It is also known that concomitant use of [[lithium]] with other neuroleptics may, in rare cases, cause encephalopathy.


==Signs and symptoms==
== [[Encephalopathy differential diagnosis|Differential Diagnosis]] ==
The hallmark of encephalopathy is an altered mental state. Depending on the type and severity of encephalopathy, common neurological symptoms are progressive loss of memory and cognitive ability, subtle personality changes, inability to concentrate, lethargy, and progressive loss of consciousness. Other neurological symptoms may include [[myoclonus]] (involuntary twitching of a muscle or group of muscles), [[nystagmus]] (rapid, involuntary eye movement), tremor, muscle [[atrophy]] and weakness, [[dementia]], [[seizure]]s, and loss of ability to swallow or speak.


==Diagnosis==
== [[Encephalopathy risk factors|Risk Factors]] ==
[[Blood test]]s, spinal fluid examination by [[lumbar puncture]], imaging studies, [[electroencephalography]].


==Therapy==
== [[Encephalopathy natural history|Natural History, Complications and Prognosis]] ==
Treatment is symptomatic and varies, according to the type and severity of the encephalopathy.  [[Anticonvulsant]]s may be prescribed to reduce or halt any seizures. Changes to diet and nutritional supplements may help some patients. In severe cases, dialysis or organ replacement surgery may be needed.


==Prognosis==
== Diagnosis ==
Treating the underlying cause of the disorder may improve or reverse symptoms.  However, in some cases, the encephalopathy may cause permanent structural changes and irreversible damage to the brain.  Some encephalopathies can be fatal.


==References==
[[Encephalopathy history and symptoms|History and Symptoms]] | [[Encephalopathy physical examination|Physical Examination]] | [[Encephalopathy laboratory tests|Laboratory Findings]] | [[Encephalopathy electrocardiogram|ECG]]  | [[Encephalopathy  electroencephalogram|EEG]] | [[Encephalopathy chest x ray|Chest X Ray]] |[[Encephalopathy CT|CT]] | [[Encephalopathy MRI|MRI]] | [[Encephalopathy echocardiography or ultrasound|Echocardiography or Ultrasound]] |[[Encephalopathy other imaging findings|Other Imaging Findings]] | [[Encephalopathy other diagnostic studies|Other Diagnostic Studies]]
* Adapted from http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm
''The Diagnosis of Stupor and Coma'' by Plum and Posner ISBN 0195138988 remains one the of best detailed observational references to the condition


==See also==
== Treatment ==
*[[Brain damage]]
 
*[[Neurobiology]]
[[Encephalopathy medical therapy|Medical therapy]] | [[Encephalopathy surgery|Surgery]] | [[Encephalopathy prevention|Prevention]] | [[Encephalopathy cost-effectiveness of therapy|Cost-effectiveness of Therapy]]| [[Encephalopathy future or investigational therapies|Future or Investigational Therapies]]
*[[Neurobiological brain disorder]]
 
== See also ==
 
* [[Brain damage]]


{{CNS diseases of the nervous system}}
{{CNS diseases of the nervous system}}
{{SIB}}


[[Category:Neurology]]
[[Category:Neurology]]
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[[Category:Emergency medicine]]
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[[Category:Signs and symptoms]]
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[[Category:Disease]]
 


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[[ru:Энцефалопатия]]
 


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Latest revision as of 17:39, 4 June 2015


Encephalopathy
Binswangers Subcortical Encephalopathy: Gross fixed tissue horizontal section cerebral hemispheres at level of genu internal capsule
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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