HEPATIC COMA
Authors: PAUL W. CLOUGH
Journal: Annals of Internal Medicine (1960)

Editorials1 October 1960HEPATIC COMAPAUL W. CLOUGH, M.D.PAUL W. CLOUGH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-53-4-848 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNeuropsychiatry disturbances progressing at times to actual coma have been recognized for many years as a not infrequent complication of the terminal stages of cirrhosis. In fact excerpts from medical writers of antiquity have been quoted as possibly descriptions of such a condition. It has been recognized for many years that this "hepatic coma" was quite distinct from uremic and diabetic coma and that it was not associated with intracranial lesions or other generally recognized causes of such psychic disturbances. Until recently, however, nothing precise was known regarding its pathogenesis.The first major lead to an understanding of this condition...1 SummerskillDavidsonSherlockSteiner WHEASRE: The neuropsychiatric syndrome associated with hepatic cirrhosis and an extensive portal collateral circulation, Quart. J. Med. 25: 245-266, 1956. MedlineGoogle Scholar2 AdamsFoley RDJM: Neurological disorder associated with liver disease, A. Res. Nerv. and Ment. Dis., Proc. (1953) 32: 198-237, 1953. MedlineGoogle Scholar3 PhillipsSchwartzGabusdaDavidson GBRGJCS: The syndrome of impending hepatic coma in patients with cirrhosis of the liver given certain nitrogenous substances, New England J. Med. 247: 239-246, 1952. CrossrefMedlineGoogle Scholar4 Sherlock S: Pathogenesis and management of hepatic coma, Am. J. Med. 24: 805-813, 1958. CrossrefMedlineGoogle Scholar5 SherlockSummerskillWhitePhear SWHLPEA: Portal-systemic encephalopathy. Neurological complications of liver disease, Lancet 2: 453, 1954. CrossrefGoogle Scholar6 WhitePhearSummerskillSherlock LPEAWHS: Ammonium tolerance in liver disease: observations based on catheterization of the hepatic veins, J. Clin. Investigation 34: 158-168, 1955. CrossrefMedlineGoogle Scholar7 SummerskillWolfeDavidson WHSJCS: The metabolism of ammonia and α-keto acids in liver disease and hepatic coma, J. Clin. Investigation 36: 361-372, 1957. CrossrefMedlineGoogle Scholar8 SeegmillerSchwartzDavidson JERCS: The plasma "ammonia" and glutamine content in patients with hepatic coma, J. Clin. Investigation 33: 984-988, 1954. CrossrefMedlineGoogle Scholar9 Fahey JL: Toxicity and blood ammonia rise resulting from intravenous amino acid administration in man, J. Clin. Investigation 36: 1647-1655, 1957. CrossrefMedlineGoogle Scholar10 McDermottAdams WVRD: Episodic stupor associated with an Eck fistula in the human with particular reference to the metabolism of ammonia, J. Clin. Investigation 33: 1-9, 1954. CrossrefMedlineGoogle Scholar11 MagnumLamonsFriedlander JDWJ: Neurologic changes in a patient with portacaval shunt and the relationship to hepatic coma, Am. J. Med. 21: 306-311, 1956. CrossrefMedlineGoogle Scholar12 ZieveMendelsonGoepfert LDFM: Shunt encephalomyelopathy. I. Recurrent protein encephalopathy with response to arginine, Ann. Int. Med. 53: 32, 1960. Google Scholar13 ZieveMendelsonGoepfert LDFM: Shunt encephalomyelopathy. II. Occurrence of permanent myelopathy, Ann. Int. Med. 53: 53, 1960. LinkGoogle Scholar14 NajarianHarper JSHA: A clinical study of the effect of arginine on blood ammonia, Am. J. Med. 21: 832-842, 1956. CrossrefMedlineGoogle Scholar15 FaheyNathansRairigh JLDD: Effect of 1-arginine on elevated blood ammonia levels in man, Am. J. Med. 22: 860-869, 1957. CrossrefGoogle Scholar16 ReynoldsRedekerDavis TBAGP: A controlled study of the effects of 1-arginine on hepatic encephalopathy, Am. J. Med. 25: 359-367, 1958. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySome Psychiatric Syndromes in Internal Medicine 1 October 1960Volume 53, Issue 4Page: 848-853KeywordsCirrhosisComaLesionsPathogenesis Issue Published: 1 October 1960 PDF DownloadLoading ...