288 lines
No EOL
32 KiB
HTML
288 lines
No EOL
32 KiB
HTML
<!DOCTYPE html>
|
||
<html lang="en" id="article" class="nojs us" data-root="//medlineplus.gov" itemid="https://medlineplus.gov/ency/article/000302.htm" itemtype="http://schema.org/MedicalWebPage" itemscope="">
|
||
<head>
|
||
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"/>
|
||
<meta http-equiv="window-target" content="_top"/>
|
||
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8"/>
|
||
<meta charset="utf-8"/>
|
||
<meta property="fb:app_id" content="1042245625821448"/>
|
||
<meta name="expires" content="Wed, 05 02 2025"/>
|
||
<meta name="ac-dictionary" content="medlineplus-ac-dictionary"/>
|
||
<link rel="shortcut icon" href="https://medlineplus.gov/images/favicon.ico" type="image/x-icon"/>
|
||
<link rel="apple-touch-icon" href="//medlineplus.gov/images/touch-icon.png"/>
|
||
<meta name="viewport" content="width=device-width, initial-scale=1"/>
|
||
<link rel="stylesheet" href="https://medlineplus.gov/css/common_new.css?04272023"/>
|
||
<!--[if IE 8]> <link rel="stylesheet" href="https://medlineplus.gov/css/ie8/common.css"><![endif]-->
|
||
<link rel="stylesheet" href="https://medlineplus.gov/uswds/css/uswds_styles.css"/>
|
||
<link rel="stylesheet" href="https://medlineplus.gov/css/ency/ency2.css?07162024"/>
|
||
<script type="text/javascript">document.querySelector("html").className = document.querySelector("html").className.replace(/nojs[\s]*/g, '');</script>
|
||
<script src="https://medlineplus.gov/uswds/js/uswds-init.min.js" type="text/javascript">
|
||
</script>
|
||
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-MMVM77');</script>
|
||
<link rel="canonical" href="https://medlineplus.gov/ency/article/000302.htm" itemprop="url"/>
|
||
<link rel="alternative" hreflang="es" href="https://medlineplus.gov/spanish/ency/article/000302.htm"/>
|
||
<link rel="alternative" hreflang="en" href="https://medlineplus.gov/ency/article/000302.htm"/><meta property="og:title" content="Loss of brain function - liver disease: MedlinePlus Medical Encyclopedia"/><meta property="og:url" content="https://medlineplus.gov/ency/article/000302.htm"/><meta property="twitter:title" content="Loss of brain function - liver disease: MedlinePlus Medical Encyclopedia"/><meta name="twitter:card" content="summary_large_image"/><meta name="description" content="Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time."/><meta itemprop="description" name="description" content="Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time."/><meta property="og:description" content="Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time."/><meta property="twitter:description" content="Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time."/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_2.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_3.jpg"/><meta property="twitter:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/>
|
||
<title>Loss of brain function - liver disease: MedlinePlus Medical Encyclopedia</title>
|
||
</head>
|
||
<body><link href="http://schema.org/Patient" itemprop="audience"/>
|
||
<!-- Google Tag Manager -->
|
||
<noscript><iframe title="googletagmanager" src="//www.googletagmanager.com/ns.html?id=GTM-MMVM77" height="0" width="0" style="display:none;visibility:hidden">
|
||
</iframe>
|
||
</noscript>
|
||
<!-- End Google Tag Manager -->
|
||
<a name="top" id="top">
|
||
</a>
|
||
<a class="hide-offscreen" href="#start">Skip navigation</a>
|
||
<section class="usa-banner" aria-label="Official website of the United States government">
|
||
<div class="usa-accordion">
|
||
<header class="usa-banner__header">
|
||
<div class="usa-banner__inner">
|
||
<div class="grid-col-auto">
|
||
<img aria-hidden="true" class="usa-banner__header-flag" src="https://medlineplus.gov/uswds/img/us_flag_small.png" alt=""/>
|
||
</div>
|
||
<div class="grid-col-fill tablet:grid-col-auto" aria-hidden="true">
|
||
<p class="usa-banner__header-text">
|
||
An official website of the United States government
|
||
</p>
|
||
<p class="usa-banner__header-action">Here’s how you know</p>
|
||
</div>
|
||
<button type="button" class="usa-accordion__button usa-banner__button" aria-expanded="false" aria-controls="gov-banner-default-default">
|
||
<span class="usa-banner__button-text">Here’s how you know</span>
|
||
</button>
|
||
</div>
|
||
</header>
|
||
<div class="usa-banner__content usa-accordion__content" id="gov-banner-default-default">
|
||
<div class="grid-row grid-gap-lg">
|
||
<div class="usa-banner__guidance tablet:grid-col-6">
|
||
<img class="usa-banner__icon usa-media-block__img" src="https://medlineplus.gov/uswds/img/icon-dot-gov.svg" role="img" alt="" aria-hidden="true"/>
|
||
<div class="usa-media-block__body">
|
||
<p>
|
||
<strong>Official websites use .gov</strong><br/>A
|
||
<strong>.gov</strong> website belongs to an official government
|
||
organization in the United States.
|
||
</p>
|
||
</div>
|
||
</div>
|
||
<div class="usa-banner__guidance tablet:grid-col-6">
|
||
<img class="usa-banner__icon usa-media-block__img" src="https://medlineplus.gov/uswds/img/icon-https.svg" role="img" alt="" aria-hidden="true"/>
|
||
<div class="usa-media-block__body">
|
||
<p>
|
||
<strong>Secure .gov websites use HTTPS</strong><br/>A
|
||
<strong>lock</strong> (
|
||
<span class="icon-lock"><svg xmlns="http://www.w3.org/2000/svg" width="52" height="64" viewBox="0 0 52 64" class="usa-banner__lock-image" role="img" aria-labelledby="banner-lock-description-default" focusable="false">
|
||
<title id="banner-lock-title-default">Lock</title>
|
||
<desc id="banner-lock-description-default">Locked padlock icon</desc>
|
||
<path fill="#000000" fill-rule="evenodd" d="M26 0c10.493 0 19 8.507 19 19v9h3a4 4 0 0 1 4 4v28a4 4 0 0 1-4 4H4a4 4 0 0 1-4-4V32a4 4 0 0 1 4-4h3v-9C7 8.507 15.507 0 26 0zm0 8c-5.979 0-10.843 4.77-10.996 10.712L15 19v9h22v-9c0-6.075-4.925-11-11-11z">
|
||
</path>
|
||
</svg> </span>) or <strong>https://</strong> means you’ve safely connected to
|
||
the .gov website. Share sensitive information only on official,
|
||
secure websites.
|
||
</p>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</section>
|
||
<div id="mplus-wrap">
|
||
<header>
|
||
<div id="mplus-header">
|
||
<!-- Orgs
|
||
================================================== -->
|
||
<div id="mplus-orgs">
|
||
<a title="National Institutes of Health" target="_blank" class="nih-org" href="//www.nih.gov/">
|
||
<img alt="National Institutes of Health" src="https://medlineplus.gov/images/nihlogo.png" class="nihlogo"/>
|
||
</a><a target="_blank" href="https://www.nlm.nih.gov/"> National Library of Medicine </a>
|
||
</div>
|
||
<!-- Logo
|
||
================================================== -->
|
||
<div id="mplus-logo" class="years-25">
|
||
<a href="https://medlineplus.gov">
|
||
<img src="https://medlineplus.gov/images/m_logo_25.png" title="MedlinePlus Trusted Health Information for You" alt="MedlinePlus Trusted Health Information for You"/>
|
||
</a>
|
||
</div>
|
||
<!-- Nav Menu
|
||
================================================== -->
|
||
<div id="mplus-nav">
|
||
<div class="sm-live-area hide-offscreen" aria-live="polite">The navigation menu has been collapsed.</div>
|
||
<!-- Menu Button-->
|
||
<button type="submit" aria-controls="mplus-menu-list" role="button" title="Menu" class="navmenu-btn" id="sm-menu-btn" aria-pressed="false" tabindex="0">Menu<span class="icon icon-nav-menu">
|
||
</span></button><ul class="nav-list" id="mplus-menu-list">
|
||
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li>
|
||
<li><a href="https://medlineplus.gov/druginformation.html">Drugs & Supplements</a></li>
|
||
<li><a href="https://medlineplus.gov/genetics/">Genetics</a></li>
|
||
<li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li>
|
||
<li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
|
||
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
|
||
</ul><button type="submit" aria-controls="mplus-search" role="button" title="Search" class="navmenu-btn" id="sm-search-btn" aria-pressed="false" tabindex="0"><span class="hide-offscreen">Show </span>Search<span class="icon icon-nav-search">
|
||
</span></button>
|
||
<div class="top-1">
|
||
<!-- Search
|
||
================================================== -->
|
||
<form target="_self" title="Search MedlinePlus" action="//vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta" method="get" id="mplus-search">
|
||
<input type="hidden" value="medlineplus" name="v:project"/>
|
||
<input type="hidden" value="medlineplus-bundle" name="v:sources"/>
|
||
<div class="form-box text-combo">
|
||
<div class="form-area"><label for="searchtext_primary" class="hide-offscreen">Search MedlinePlus</label>
|
||
<span role="status" aria-live="polite" class="ui-helper-hidden-accessible">
|
||
</span><input type="text" aria-haspopup="true" aria-autocomplete="list" role="textbox" autocomplete="off" name="query" size="40" maxlength="400" title="Site Search input" alt="Site Search input" placeholder="Search MedlinePlus" class="form-text ui-autocomplete-input" id="searchtext_primary"/>
|
||
</div>
|
||
<div class="button-area">
|
||
<button type="submit" alt="Search MedlinePlus" title="Search MedlinePlus" class="form-btn">GO</button>
|
||
</div>
|
||
</div>
|
||
</form>
|
||
<!-- Secondary Nav
|
||
================================================== -->
|
||
<div class="secondarynav">
|
||
<ul class="nav-list">
|
||
<li><a href="https://medlineplus.gov/about/"><span>About MedlinePlus</span></a></li>
|
||
<li><a href="https://medlineplus.gov/whatsnew/"><span>What's New</span></a></li>
|
||
<li><a href="https://medlineplus.gov/sitemap.html"><span>Site Map</span></a></li>
|
||
<li><a target="_blank" href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&category=medlineplus&from=//medlineplus.gov/ency/article/000302.htm"><span>Customer Support</span></a></li>
|
||
</ul>
|
||
</div>
|
||
</div>
|
||
<!-- Nav Bar
|
||
================================================== -->
|
||
<div id="mplus-nav-bar">
|
||
<ul class="nav-list">
|
||
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li><li><a href="https://medlineplus.gov/druginformation.html">Drugs & Supplements</a></li><li><a href="https://medlineplus.gov/genetics/">Genetics</a></li><li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li><li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
|
||
</ul>
|
||
</div>
|
||
<a title="Español" id="mplus-lang-toggle" href="../../spanish/ency/article/000302.htm">Español</a>
|
||
</div>
|
||
</div>
|
||
</header>
|
||
<!-- Content
|
||
================================================== -->
|
||
<div id="mplus-content">
|
||
<!-- Breadrcumbs -->
|
||
<div id="breadcrumbs"><div itemtype="http://schema.org/BreadcrumbList" itemscope="" itemprop="breadcrumb"><span class="hide-offscreen">You Are Here:</span>
|
||
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
|
||
<a href="https://medlineplus.gov" itemprop="item"><span itemprop="name">Home</span></a>
|
||
→
|
||
<meta itemprop="position" content="1"/>
|
||
</div>
|
||
|
||
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
|
||
<a href="https://medlineplus.gov/encyclopedia.html" itemprop="item"><span itemprop="name">Medical Encyclopedia</span></a>
|
||
→
|
||
<meta itemprop="position" content="2"/>
|
||
</div>
|
||
</div><div><span>Loss of brain function - liver disease</span></div></div>
|
||
<span class="page-url print-only">URL of this page: //medlineplus.gov/ency/article/000302.htm
|
||
</span>
|
||
<!-- Article -->
|
||
<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
|
||
</a><h1 class="with-also" itemprop="name">Loss of brain function - liver disease</h1>
|
||
</div><div class="page-actions">
|
||
</div>
|
||
<noscript>
|
||
<span class="js-disabled-message">To use the sharing features on this page, please enable JavaScript.</span>
|
||
</noscript></div><div class="main"><div id="ency_summary"><p>Loss of brain function occurs when the liver is unable to remove toxins from the blood<span>. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time.</span></p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-1"><p>An important function of the liver is to make toxic substances in the body harmless. These substances may be made by the body (ammonia), or substances that you take in (medicines).</p><p>When the liver is damaged, these "poisons" can build up in the bloodstream and affect the function of the nervous system. The result may be HE.</p><p>HE can occur suddenly and you may become ill very quickly. Causes of HE may include:</p><ul><li>Hepatitis A or B infection (uncommon to occur this way)</li><li>Blockage of blood supply to the liver</li><li>Poisoning by different toxins or medicines</li><li>Constipation</li><li>Upper gastrointestinal bleeding</li></ul><p>People with severe liver damage often suffer from HE. The end result of chronic liver damage is cirrhosis. Common causes of chronic liver disease are:</p><ul><li>Severe hepatitis <a test="test" href="./000279.htm">B</a> or <a test="test" href="./000284.htm">C</a> infection</li><li><a test="test" href="./000944.htm">Alcohol abuse</a></li><li><a test="test" href="./000245.htm">Autoimmune</a> hepatitis</li><li>Bile duct disorders</li><li>Some medicines</li><li>Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)</li></ul><p>Once you have liver damage, episodes of worsening brain function may be triggered by:</p><ul><li>Loss of body fluids (dehydration)</li><li>Eating too much protein</li><li>Low blood potassium or sodium levels</li><li>Bleeding in the intestines, stomach, or food pipe (esophagus)</li><li>Infections</li><li>Kidney problems</li><li>Low oxygen levels in the body</li><li>Shunt placement or complications</li><li>Surgery</li><li>Narcotic pain or sedative medicines</li></ul><p>Disorders that can appear similar to HE may include:</p><ul><li>Alcohol intoxication</li><li>Alcohol withdrawal</li><li>Bleeding inside the skull (<a test="test" href="./000713.htm">subdural hematoma</a>)</li><li>Brain disorder caused by lack of vitamin B1 (<a test="test" href="./000771.htm">Wernicke-Korsakoff syndrome</a>)</li></ul><p>In some cases, HE is a short-term problem that can be corrected. It may also occur as part of a long-term (chronic) problem from liver disease that gets worse over time.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-2"><p>Symptoms of HE are graded on a scale of grades 1 to 4. They may begin slowly and worsen over time.</p><p>Early symptoms may be mild and include:</p><ul><li>Breath with a musty or sweet odor</li><li>Changes in sleep patterns</li><li>Changes in thinking</li><li>Mild confusion</li><li>Forgetfulness</li><li>Personality or mood changes</li><li>Poor concentration and judgment</li><li>Worsening of handwriting or loss of other small hand movements</li></ul><p>Severe symptoms may include:</p><ul><li>Abnormal movements or shaking of hands or arms</li><li>Agitation, excitement, or seizures (occur rarely)</li><li>Disorientation</li><li>Drowsiness or confusion</li><li>Behavior or personality changes</li><li>Slurred speech</li><li>Slowed or sluggish movement</li></ul><p>People with HE can become unconscious, unresponsive, and possibly enter into a coma.</p><p>People are often not able to care for themselves because of these symptoms.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-3"><p>Signs of nervous system changes may include:</p><ul><li>Shaking of the hands ("flapping tremor" or asterixis) when trying to hold arms in front of the body and lift the hands</li><li>Problems with thinking and doing mental tasks</li><li>Signs of <a test="test" href="./000205.htm">liver disease</a>, such as yellow skin and eyes (jaundice) and fluid collection in the abdomen (<a test="test" href="./000286.htm">ascites</a>)</li><li>Musty odor to the breath and urine</li></ul><p>Tests done may include:</p><ul><li>Complete blood count or hematocrit to check for anemia</li><li><a test="test" href="./003786.htm">CT scan of the head</a> or <a test="test" href="./003791.htm">MRI</a></li><li><a test="test" href="./003931.htm">EEG</a></li><li><a test="test" href="./003436.htm">Liver function tests</a></li><li><a test="test" href="./003652.htm">Prothrombin time</a></li><li>Serum ammonia level in the blood </li><li><a test="test" href="./003481.htm">Sodium level in the blood</a></li><li><a test="test" href="./003484.htm">Potassium level in the blood</a></li><li><a test="test" href="./003474.htm">BUN</a> (blood urea nitrogen) and blood <a test="test" href="./003475.htm">creatinine</a> to see how the kidneys are working </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-4"><p>Treatment of HE depends upon the cause.</p><p>If changes in brain function are severe, a hospital stay may be needed.</p><ul><li>Bleeding in the digestive tract must be stopped.</li><li>Infections, kidney failure, and changes in sodium and potassium levels need to be treated. </li></ul><p>Medicines are given to help lower ammonia level and improve brain function. Medicines given may include:</p><ul><li>Lactulose to prevent bacteria in the intestines from creating ammonia. It may cause diarrhea.</li><li>Neomycin and rifaximin also reduce the amount of ammonia made in the intestines.</li><li>If the HE improves while taking rifaximin, it should be continued indefinitely. </li></ul><p>You should avoid:</p><ul><li>Any sedatives, tranquilizers, and any other medicines that are broken down by the liver</li><li>Medicines containing ammonium (including certain antacids) </li></ul><p>Your health care provider may suggest other medicines and treatments. These may have varying results.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-5"><p>The outlook of HE depends on the management of the cause of HE. Chronic forms of the disorder often continue to get worse and come back.</p><p>The first two stages of the disease have a good prognosis. Stage three and four have a poor prognosis. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-6"><p>Contact your provider if you or people around you notice any problems with your mental state or nervous system function. This is important for people who already have a liver disorder. HE can get worse quickly and become an emergency condition.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-7"><p>Treating liver problems may prevent HE. Avoiding alcohol and intravenous drugs can prevent many liver disorders.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-Alt"><p>Hepatic coma; Encephalopathy - hepatic; Hepatic encephalopathy; Portosystemic encephalopathy</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-Ref"><p>Cameron J. Portal hypertension. In: Cameron J, ed. <em>Current Surgical Therapy</em>. 14th ed. Philadelphia, PA: Elsevier; 2023:413-456.</p><p>Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Cooney KA, eds. <em>Goldman-Cecil Medicine</em>. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.</p><p>Mehta SS, Fallon MB. Hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, and other systemic complications of liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. <em>Sleisenger and Fordtran's Gastrointestinal and Liver Disease</em>. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 94.</p><p>Wong MP, Moitra VK. Hepatic encephalopathy. In: Fleisher LA, Roizen MF, Roizen JD, eds. <em>Essence of Anesthesia Practice</em>. 4th ed. Philadelphia, PA: Elsevier; 2018:198-198.</p></div></div></section>
|
||
<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 8/7/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div>
|
||
<div id="section-version" class="section-body"><p>Updated by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
|
||
</div></div></section><section><div class="section ency-citation"><div class="section-header"><div class="section-title ency-citation"><div id="citation-how-to"><button><span>Learn how to cite this page</span></button></div></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Related MedlinePlus Health Topics</h2></div><div class="section-button"><button type="submit" aria-controls="section-mtp" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div name="Related MedlinePlus Health Topics" class="section-body" id="section-mtp"><ul class="side-nav"><li><a href="https://medlineplus.gov/braindiseases.html">Brain Diseases</a></li>
|
||
<li><a href="https://medlineplus.gov/cirrhosis.html">Cirrhosis</a></li>
|
||
<li><a href="https://medlineplus.gov/liverdiseases.html">Liver Diseases</a></li>
|
||
</ul></div></div></section></div></div></article>
|
||
</div>
|
||
<footer>
|
||
|
||
<div class="provider-box group">
|
||
<div class="urac-logo">
|
||
<a href="https://accreditnet.urac.org/directory/#/certification/HCP-2/info"><img src="https://medlineplus.gov/images/CertifiedSeal.png"/></a>
|
||
<p class="urac-logo-info">Health Content Provider<br>06/01/2025</p>
|
||
</div>
|
||
<p class="adam-info">
|
||
<a href='javascript:urac_open();'>A.D.A.M., Inc. is accredited by URAC</a>, for Health Content Provider (www.urac.org). URAC's <a href='javascript:hwsopen();'>accreditation program</a> is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s <a href='javascript:edpolopen();'>editorial policy, editorial process</a>, and <a href='javascript:ppopen();'>privacy policy</a>. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: <a href='javascript:honc_open();'>verify here</a>.
|
||
</p>
|
||
</div>
|
||
<p class="adam-info">
|
||
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only – they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997-2025 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
|
||
</p>
|
||
<div class="adam-logo">
|
||
<a href="https://www.adam.com/about" target="_blank"><img width="49" height="10" alt="About A.D.A.M." src="https://medlineplus.gov/ency/images/ency/ftrAdamlogo.gif"/></a>
|
||
</div>
|
||
<div id="mplus-footer">
|
||
<div class="footer1">
|
||
<ul class="secondarynav">
|
||
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
|
||
<li><a href="https://medlineplus.gov/whatsnew/">What's New</a></li>
|
||
<li><a href="https://medlineplus.gov/sitemap.html">Site Map</a></li>
|
||
<li><a name="contact" target="_blank" href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&category=medlineplus&from="><span>Customer Support</span></a></li>
|
||
</ul>
|
||
<ul class="follow-footer">
|
||
<li><a href="https://medlineplus.gov/rss.html" class="follow-item">Subscribe to RSS<img src="https://medlineplus.gov/images/feed.png" class="social-media-toolkit-icon" alt="RSS" title="RSS"></a></li>
|
||
<li><span class="follow-label">Follow us</span>
|
||
<a href="https://twitter.com/medlineplus" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/i_share_twitter.png" class="follow-icon" alt="X" title="X"></a>
|
||
<a href="https://facebook.com/Mplus.gov/" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/i_share_fb.png" class="follow-icon" alt="Facebook" title="Facebook"></a>
|
||
<a href="https://www.instagram.com/mplusgov/" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/Instagram_Glyph_Gradient_RGB.png" class="follow-icon" alt="Instagram" title="Instagram"></a>
|
||
</li>
|
||
<li><a href="https://medlineplus.gov/social-media-toolkit/" class="social-media-toolkit-item">Social Media Toolkit<img src="https://medlineplus.gov/images/i_social_media_toolkit.png" class="social-media-toolkit-icon" alt="Social Media Toolkit" title="Social Media Toolkit"></a></li>
|
||
</ul>
|
||
</div>
|
||
<div class="footer2">
|
||
<ul>
|
||
<li><a href="https://www.nlm.nih.gov/web_policies.html" target="_blank">NLM Web Policies</a></li>
|
||
<li><a href="https://medlineplus.gov/about/using/usingcontent/" >Copyright</a></li>
|
||
<li><a href="//medlineplus.gov/accessibility.html">Accessibility</a></li>
|
||
<li><a href="https://medlineplus.gov/about/using/criteria/">Guidelines for Links</a></li>
|
||
<li><a href="//medlineplus.gov/plugins.html">Viewers & Players</a></li>
|
||
<li><a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" target="_blank">HHS Vulnerability Disclosure</a></li>
|
||
<li><a href="https://medlineplus.gov/medlineplus-connect/">MedlinePlus Connect for EHRs</a></li>
|
||
<li><a href="https://medlineplus.gov/about/developers/">For Developers</a></li>
|
||
</ul>
|
||
<div class="address">
|
||
<a href="//www.nlm.nih.gov" target="_blank">National Library of Medicine</a>
|
||
<span>8600 Rockville Pike, Bethesda, MD 20894</span>
|
||
<a href="//www.hhs.gov" target="_blank">U.S. Department of Health and Human Services</a>
|
||
<a href="//www.nih.gov" target="_blank">National Institutes of Health</a>
|
||
</div>
|
||
<div class="return-top"><a href="#top" title="Return to top"><img class="return-top-icon" alt="Return to top" src="https://medlineplus.gov/images/return-top.png"></a></div>
|
||
</div>
|
||
</div>
|
||
|
||
</footer>
|
||
</div><!-- End Wrap -->
|
||
<script src="https://medlineplus.gov/jslib/jquery-3.6.0.min.js" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/jslib/mplus-frontend-controls.js" type="text/javascript">
|
||
</script>
|
||
<!--[if lte IE 9]>
|
||
<script src="https://medlineplus.gov/jslib/jquery.placeholder.js" type="text/javascript"></script>
|
||
<![endif]-->
|
||
<script src="https://medlineplus.gov/jslib/mplus-share.js?id=1112022" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/jslib/control.js" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/uswds/js/uswds.min.js" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/jslib/ency/ency.js" type="text/javascript">
|
||
</script>
|
||
</body>
|
||
</html> |