Hepatic encephalopathy history and symptoms: Difference between revisions
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===Common Symptoms=== | ===Common Symptoms=== | ||
Common symptoms of | Common symptoms of hepatic encephalopathy include: | ||
*[ | *[[personality changes]] | ||
*[ | *Altered level of [[consciousness]] | ||
*[ | *J[[jerking|erking]] movement of the limbs([[asterixis]]) | ||
*[[confusion]] | |||
*i[[irritability|rritability]] | |||
*[ | *Inverted [[sleep-wake pattern]](combination of restless nights and excessive daytime sleepiness) | ||
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*[ | |||
==References== | ==References== | ||
{{Reflist|2}}{{WH}} {{WS}} | {{Reflist|2}}{{WH}} {{WS}} | ||
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Overview
In patients with hepatic encephalopathy, symptoms may begin slowly and gradually worsen, or may begin suddenly and be very fast. the hallmark of hepatic encephalopathy is hyperammonemia. A positive history of hepatic failure is suggestive of hepatic encephalopathy. The most common symptoms of hepatic encephalopathy include inverted sleep-wake pattern(combination of restless nights and excessive daytime sleepiness), personality changes, altered level of consciousness, jerking movement of the limbs(asterixis), confusion and irritability.
History and Symptoms
In patients with hepatic encephalopathy, symptoms may begin slowly and gradually worsen, or may begin suddenly and be very fast. the hallmark of hepatic encephalopathy is hyperammonemia.[1] A positive history of hepatic failure is suggestive of hepatic encephalopathy. The most common symptoms of hepatic encephalopathy include inverted sleep-wake pattern(combination of restless nights and excessive daytime sleepiness)[2], personality changes[3], altered level of consciousness[4], jerking movement of the limbs(asterixis)[5], confusion and irritability.[6]
History
Patients with hepatic encephalopathy may have a positive history of:[7][8][3][6][9][10][11]
Common Symptoms
Common symptoms of hepatic encephalopathy include:
- personality changes
- Altered level of consciousness
- Jerking movement of the limbs(asterixis)
- confusion
- irritability
- Inverted sleep-wake pattern(combination of restless nights and excessive daytime sleepiness)
References
- ↑ Rimar D, Kruzel-Davila E, Dori G, Baron E, Bitterman H (2007). "Hyperammonemic coma--barking up the wrong tree". J Gen Intern Med. 22 (4): 549–52. doi:10.1007/s11606-007-0131-6. PMC 1829435. PMID 17372808.
- ↑ Montagnese S, Turco M, Amodio P (2015). "Hepatic encephalopathy and sleepiness: an interesting connection?". J Clin Exp Hepatol. 5 (Suppl 1): S49–53. doi:10.1016/j.jceh.2014.06.006. PMC 4442851. PMID 26041958.
- ↑ 3.0 3.1 Ferenci P (2017). "Hepatic encephalopathy". Gastroenterol Rep (Oxf). 5 (2): 138–147. doi:10.1093/gastro/gox013. PMC 5421503. PMID 28533911.
- ↑ al-Arif A, Sporn MB (1972). "2'-O-methylation of adenosine, guanosine, uridine, and cytidine in RNA of isolated rat liver nuclei". Proc Natl Acad Sci U S A. 69 (7): 1716–9. PMC 426785. PMID 4340155.
- ↑ Agarwal R, Baid R (2016). "Asterixis". J Postgrad Med. 62 (2): 115–7. doi:10.4103/0022-3859.180572. PMC 4944342. PMID 27089111.
- ↑ 6.0 6.1 Bleibel W, Al-Osaimi AM (2012). "Hepatic encephalopathy". Saudi J Gastroenterol. 18 (5): 301–9. doi:10.4103/1319-3767.101123. PMC 3500018. PMID 23006457.
- ↑ Djiambou-Nganjeu H (2017). "Hepatic Encephalopathy in Liver Cirrhosis". J Transl Int Med. 5 (1): 64–67. doi:10.1515/jtim-2017-0013. PMC 5490964. PMID 28680841.
- ↑ Acharya SK (2015). "Management in acute liver failure". J Clin Exp Hepatol. 5 (Suppl 1): S104–15. doi:10.1016/j.jceh.2014.11.005. PMC 4442864. PMID 26041950.
- ↑ Jepsen P, Christensen J, Weissenborn K, Watson H, Vilstrup H (2016). "Epilepsy as a risk factor for hepatic encephalopathy in patients with cirrhosis: a cohort study". BMC Gastroenterol. 16 (1): 77. doi:10.1186/s12876-016-0487-3. PMC 4960784. PMID 27457247.
- ↑ Guevara M, Baccaro ME, Ríos J, Martín-Llahí M, Uriz J, Ruiz del Arbol L; et al. (2010). "Risk factors for hepatic encephalopathy in patients with cirrhosis and refractory ascites: relevance of serum sodium concentration". Liver Int. 30 (8): 1137–42. doi:10.1111/j.1478-3231.2010.02293.x. PMID 20602681.
- ↑ Jepsen P, Watson H, Andersen PK, Vilstrup H (2015). "Diabetes as a risk factor for hepatic encephalopathy in cirrhosis patients". J Hepatol. 63 (5): 1133–8. doi:10.1016/j.jhep.2015.07.007. PMID 26206073.
Overview
One of the earliest manifestations of hepatic encephalopathy is "day-night reversal". In other words, affected individuals tend to sleep during the day and stay awake at night. Another early manifestation is impairment in spatial perception. This can be made apparent by noting the patient's poor ability to copy or draw various simple images, e.g cube, star, clock. This deficit can also be demonstrated by administering a test which has the patient connect a number of randomly placed dots on a sheet of paper (the "trail test" or "numbers connecting test").
History and Symptoms
.[1] Family members or caregivers may notice that the patient has:
- Breath with a musty or sweet odor
- Change in sleep patterns
- Changes in thinking
- Confusion that is mild
- Forgetfulness
- Mental fogginess
- Personality or mood changes
- Poor concentration
- Poor judgment
- Worsening of handwriting or loss of other small hand movements
More severe symptoms may include:
- Abnormal movements or shaking of hands or arms
- Agitation, excitement, or seizures (occur rarely)
- Disorientation
- Drowsiness or confusion
- Inappropriate behavior or severe personality changes
- Slurred speech
- Slowed or sluggish movement
Patients with hepatic encephalopathy can become unconscious, unresponsive, and possibly enter a coma. Patients with hepatic encephalopathy are often not able to care for themselves because of these symptoms.
References
- ↑ Ishii Y, Inagaki Y, Hirai K, Aoki T (2000). "Hepatic encephalopathy caused by congenital extrahepatic portosystemic venous shunt". J Hepatobiliary Pancreat Surg. 7 (5): 524–8. doi:10.1007/s005340050229. PMID 11180882.