Hepatic Encephalopathy

(Encephalopathy, Hepatic; Portal-Systemic Encephalopathy; Encephalopathy, Portal-Systemic)


Hepatic encephalopathy is a problem with the brain that is caused by liver disease. The problem may be temporary or permanent.
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A liver with disease cannot filter the harmful items in blood. These toxins build up in the blood, which reaches the brain and affects the brain’s ability to work properly.

Risk Factors

Factors that increase your chance of hepatic encephalopathy include:
  • Cirrhosis
  • Certain conditions that affect the levels of fluids and electrolytes such as hyponatremia and hyperkalemia
  • Kidney failure
  • Infections
  • Gastrointestinal bleeding
  • Certain medications such as sedatives and anti-epileptics
  • Constipation
  • Hepatitis—infectious or autoimmune


In the early stages, you may not notice any symptoms. As the condition progresses, symptoms may include:
  • Changes in behavior and personality
  • Shortened attention span
  • Depression or anxiety
  • Difficulty sleeping
  • Tiredness
  • Forgetfulness
  • Disorientation
  • Slurred speech
  • Uncontrolled movements, particularly a flapping tremor of the hands
  • Confusion
  • Loss of consciousness
If you have liver problems and any of the above symptoms, call your doctor right away.

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