page_title: Hepatic encephalopathy
section_title: Diagnosis
hierarchical_section_title: Hepatic encephalopathy / Diagnosis
caption_attribution_description: English: High magnification micrograph showing Alzheimer type II astrocytes. This is actually a micrograph of dying neurons, not astrocytes.
context_page_description: Hepatic encephalopathy is an altered level of consciousness as a result of liver failure. Its onset may be gradual or sudden. Other symptoms may include movement problems, changes in mood, or changes in personality. In the advanced stages it can result in a coma.
  Hepatic encephalopathy can occur in those with acute or chronic liver disease. Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications. The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver. The diagnosis is typically based on symptoms after ruling out other potential causes. It may be supported by blood ammonia levels, an electroencephalogram, or a CT scan of the brain.
  Hepatic encephalopathy is possibly reversible with treatment. This typically involves supportive care and addressing the triggers of the event. Lactulose is frequently used to decrease ammonia levels. Certain antibiotics and probiotics are other potential options. A liver transplant may improve outcomes in those with severe disease.
  More than 40% of people with cirrhosis develop hepatic encephalopathy.
caption: Micrograph of Alzheimer type II astrocytes, as may be seen in hepatic encephalopathy.
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