Hepatic encephalopathy natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Hepatic encephalopathy leads to changed cognitive function. This can range from subtle deficits in higher mental functions (in mild cases) to obtundation and coma (in severe cases). Left untreated, severe hepatic encephalopathy can cause death.

Natural History

Hepatic encephalopathy may occur as an acute, potentially reversible disorder. Or it may occur as a chronic, progressive disorder that is associated with chronic liver disease.

Complications

• Brain herniation
• Brain swelling
• Increased risk of:
  • Cardiovascular collapse
  • Kidney failure
  • Respiratory failure
  • Sepsis
• Permanent nervous system damage (to movement, sensation, or mental state)
• Progressive, irreversible coma
• Side effects of medications