Hepatic encephalopathy : causes, symptoms, treatment

Hepatic encephalopathy
Hepatic encephalopathy - a set of symptoms characterized by impaired hepatic function of varying severity, which can lead to severe damage to the nervous system up to coma.

There is a violation of due to chronic or acute damage to the liver parenchyma.Acute hepatic encephalopathy may develop on the background of acute hepatitis or liver disease previous background.

Hepatic encephalopathy: Causes

The main reasons for the development of hepatic encephalopathy include:

  • acute viral hepatitis type B or C, and rarely - type D, very rare - type A or E. Sometimes encephalopathy can develop on the background of other infectious diseases:yellow fever, mononucleosis, leptospirosis etc .;
  • medication hepatitis (aldomet, isoniazid, halothane, a combination of acetaminophen with alcohol);
  • excessive use of alcohol, in this case, hepatic encephalopathy most often develops on the background of chronic alcoholic liver damage in rare cases, liver disease is not preceded encephalopathy;
  • Wilson's disease;
  • fatty liver in pregnant women;
  • Budd-Chiari syndrome;
  • acute poisoning by toxic substances;
  • portocaval bypass (the creation of blood flow to bypass the liver).

Acute hepatic encephalopathy (Ray's syndrome) may develop in children (most often - aged 4-12 years) in the treatment of viral diseases with drugs containing acetylsalicylic acid.There is a dramatic swelling of the brain with the oppression of consciousness against the background of fatty liver.Therefore, with acetylsalicylic acid medications is undesirable to use in the treatment of children.

Hepatic encephalopathy: symptoms

The main clinical manifestations of hepatic encephalopathy can be distinguished, above all, mental and neuromuscular disorders, as well as changes in the electroencephalogram.

When encephalopathy in the patient manifest consciousness disorders, personality, speech and intelligence.If delirium is exacerbated, it reduces the number of spontaneous movements of the patient, there is apathy, lethargy, a fixed glance, the answers are brief.Often develops delirium.

Personality changes in chronic encephalopathy (against the background of constant drunkenness, for example) include childishness, loss of interest in friends, irritability, decrease in the number of social contacts.

Hepatic Encephalopathy: Treatment

In acute hepatic encephalopathy performed emergency hospitalization followed complexes resuscitation:.. Infusion dehydrating therapy, mechanical ventilation, control of blood gas and electrolyte parameters, etc.

treatment of hepatic encephalopathy is based on the general principles of management of patientswith liver failure.First of all, an active monitoring of the patient with all the symptoms of the disease.Every day, the patient should be weighed and evaluated fluid balance, which he uses and releases during the day.Daily sampling is carried out blood tests on the content of creatinine and electrolytes.It measured twice weekly bilirubin, albumin, and prothrombin.

is necessary to identify and address the factors that provoked hepatic encephalopathy, particularly infection.The diet should be reduced protein content and salt.The day should be taken up to 90 ml of lactulose and 30 mg of vitamin C. Daily - enema with magnesium sulfate, and vitamins of group B.

It is very important to maintain the body's normal balance of electrolytes and fluids, as well as to provide adequate high-calorie food.In addition, you must also enter the folic acid and vitamin D.

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