Medium urgency
Very common-
Alteration in brain function due to a failure in the liver's ability to remove neurotoxins in the blood.
It is caused by diseases that directly affect the liver (hepatitis, cirrhosis, etc.) or by diseases that cause a disturbance in blood flow through the liver.
It manifests with rancid (or sweet) breath, sleep disorders, mental confusion, frequent forgetfulness, personality changes, alteration of concentration, clumsiness in fine movements, tremors and tendency to become agitated.
Diagnosis is reached through medical history, physical examination and blood tests.
If the cause is known, it must be treated: digestive bleeding, infection, etc.
- Peter Ferenci. Hepatic encephalopathy in adults: Treatment. UpToDate Feb 25, 2016.
- Peter Ferenci. Hepatic encephalopathy in adults: Clinical manifestations and diagnosis. UpToDate Sep 23, 2015.
- Julio A Chalela, Scott E Kasner. Acute toxic-metabolic encephalopathy in adults. UpToDate Sep 01, 2016.
- Dahaba AA, Worm HC, Zhu SM, et al. Sensitivity and specificity of bispectral index for classification of overt hepatic encephalopathy: a multicentre, observer blinded, validation study. Gut 2008; 57:77.
- Weissenborn K, Ennen JC, Schomerus H, et al. Neuropsychological characterization of hepatic encephalopathy. J Hepatol 2001; 34:768.
- Riggio O, Ridola L, Pasquale C, et al. A simplified psychometric evaluation for the diagnosis of minimal hepatic encephalopathy. Clin Gastroenterol Hepatol 2011; 9:613.
- Bruce R Bacon. Cirrosis y sus complicaciones. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición. 2066.
- J Terés, A Más. Hemorragia Digestiva Alta. Farreras Rozman. Medicina Interna. Volumen 1. 12º edición. 311:316.
Dr. Oscar Garcia-Esquirol
Copyright© TeckelMedical 2026
