Hepatic encephalopathy

Amodio, Piero

doi:10.1002/9781118412640.ch11

Cited by 3 publications

(1 citation statement)

References 138 publications

(141 reference statements)

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“…Diagnostic tree for hepatic encephalopathy ( HE ), modified from Amodio . ART, ammonia reducing treatments…”

Section: Diagnosis and Classification Of Hepatic Encephalopathymentioning

confidence: 99%

Hepatic encephalopathy: Diagnosis and management

Amodio

2018

Liver International

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Hepatic encephalopathy (HE) is a peculiar kind of brain dysfunction caused by liver insufficiency and/or portal-systemic shunting. It is related to gut-derived substances. It is a relevant cause of morbidity and hospitalisation for patients with cirrhosis. The prognosis of HE is important in terms of survival and re-hospitalisation. It is related to impaired quality of life, falls and poor driving; presents a relevant burden for caregivers and health services; and may negatively impact on patient's job and income. Proper diagnosis and classification are expected to improve HE management. Once diagnosed, the management and therapeutic options for HE are generally clear. The improvement of knowledge in recent years has also clarified which are the further aims of research in this field of medicine. Prophylaxis of overt HE should always be performed, and this is generally secondary prophylaxis. Primary prophylaxis should be done immediately after upper gastrointestinal bleeding. Great advances in the detection and treatment of mild forms of HE are expected to lead to further improvement in patient management.

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“…Diagnostic tree for hepatic encephalopathy ( HE ), modified from Amodio . ART, ammonia reducing treatments…”

Section: Diagnosis and Classification Of Hepatic Encephalopathymentioning

confidence: 99%

Hepatic encephalopathy: Diagnosis and management

Amodio

2018

Liver International

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Recent developments in the diagnosis and treatment of covert/minimal hepatic encephalopathy

Rui

Montagnese

Amodio

2016

Expert Review of Gastroenterology & Hepatology

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The terms minimal hepatic encephalopathy and covert hepatic encephalopathy are defined. Clinical assessment is unreliable and both require the use of diagnostic tools. Of these, psychometric tests are the most widely used. They require proper standardization and may be biased by patient cooperation or lack thereof. The measure of the critical flicker frequency and of the electroencephalogram, possibly quantified, are also useful. The alteration of any of them is not strictly parallel in size and may vary from patient to patient. When possible, the use of multiple measures might increase diagnostic reliability. These functional measures should be interpreted within the clinical/biochemical profile of the patient to exclude other disorders. A flow chart for treatment is proposed on the basis of current knowledge.

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Evaluation and Management of Hepatic Encephalopathy: Current Status and Future Directions

2016

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Hepatic encephalopathy is a spectrum of neurocognitive manifestations often seen in patients with liver injury or rarely in patients with portosystemic shunting without liver injury. It can be divided into minimal (covert) hepatic encephalopathy and overt hepatic encephalopathy, depending on the severity. Patients with hepatic encephalopathy have compromised clinical outcomes, decreased quality of life, and increased healthcare utilization, often resulting in a heavy financial and personal burden on caregivers. The diagnosis remains largely clinical, with the exclusion of possible other causes for the altered mental status. Current treatment strategies include nonabsorbable disaccharides and antibiotics. This review will focus on the diagnosis, management and clinical impact of hepatic encephalopathy.

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Hepatic encephalopathy

Cited by 3 publications

References 138 publications

Hepatic encephalopathy: Diagnosis and management

Hepatic encephalopathy: Diagnosis and management

Recent developments in the diagnosis and treatment of covert/minimal hepatic encephalopathy

Evaluation and Management of Hepatic Encephalopathy: Current Status and Future Directions

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