Hepatic Function...

Definition

Pertaining to the liver.
.

Interested in getting test without leaving your own home, click here!!!

Hepatic encephalopathy is a syndrome seen in patients with cirrhosis of the liver. It is characterized by personality changes, intellectual impairment, and a depressed level of consciousness ,  fluctuating neurologic signs, asterixis or "flapping tremor," and distinctive electroencephalographic changes. An important prerequisite for the syndrome is diversion of portal blood into the systemic circulation through porto-systemic collateral vessels. Indeed, hepatic encephalopathy may develop in non-cirrhotic patients who have undergone portocaval shunt surgery. The development of hepatic encephalopathy is explained to some extent by the effect of neurotoxic substances, which occurs in the setting of cirrhosis and portal hypertension.

Subtle signs of hepatic encephalopathy are seen in nearly 70% of patients with cirrhosis. Symptoms may be debilitating in a significant number of patients and are seen in 24-53% of patients who undergo portosystemic shunt surgery. About 30% patients dying of end-stage liver disease will experience significant encephalopathy, approaching coma.

Encephalopathy may be acute and reversible or chronic and progressive. In severe cases, irreversible coma and death may occur. Acute episodes may recur with variable frequency

Hepatic encephalopathy, accompanied with severe dysfunction of the hepatic synthetic activity is also the hallmark of fulminant hepatic failure (FHF). Symptoms of encephalopathy in FHF are graded using the same scale employed to assess encephalopathy symptoms in cirrhosis. However, the pathogenesis of the encephalopathy in FHF differs from that of cirrhosis. In FHF, altered mental function is attributed to increased permeability of the blood-brain barrier and to impaired osmoregulation within the brain. The resulting brain cell swelling and brain edema is potentially fatal. In contrast, brain edema is rarely reported in cirrhosis.

Interested in getting test without leaving your own home, click here!!!