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Also known as: HE · portosystemic encephalopathy · hepatic coma
A reversible neuropsychiatric syndrome in liver failure or cirrhosis — confusion, altered sleep and asterixis (flapping tremor) that can progress to coma. There is almost always a precipitant to find and treat.
People with cirrhosis or acute liver failure; precipitants include GI bleeding, infection (including spontaneous bacterial peritonitis), constipation, dehydration/diuretics, electrolyte disturbance and sedatives.
First-line — reduce ammonia
Added for recurrent hepatic encephalopathy
Guidelines change. If something here is out of date, tell us — we keep these current.
🚩 Report outdated / suggest update