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Encephalopathy

(Glycine Encephalopathy; Hepatic Encephalopathy; Hypoxic Encephalopathy; Statin Encephalopathy; Uremic Encephalopathy; Wernicke’s Encephalopathy; Hashimoto’s Encephalopathy; Hypertensive Encephalopathy; Toxic-metabolic Encephalopathy)

Pronounced: En-SEF-a-lo-PATH-ee

Definition

Encephalopathy is condition caused by diseases that affect large portions of the brain. The disease may affect the function and/or the structure of the brain leading to a wide range of physical and mental symptoms. An altered mental state, such as confusion and sudden mood changes, is often a hallmark of encephalopathy.

There are several causes of encephalopathy. Treating the underlying disease or injury causing the encephalopathy may reverse symptoms in some. Some causes of encephalopathy may result in lasting changes in the brain. If the brain injury is severe and cannot be reversed, it can be fatal.

Causes    TOP

Encephalopathy is caused by widespread dysfunction of the brain. Some common causes include:

  • Infection
  • Head trauma
  • Metabolic dysfunction—causes an imbalance in nutrients and electrolytes the brain needs to function
  • Brain tumor or increased intracranial pressure
  • Exposure to toxins
  • Poor nutrition—causes an imbalance in nutrients and electrolytes the brain needs to function
  • No oxygen or blood flow to the brain
  • Organ failure
  • Seizures and post-seizure dysfunction

Oxygen and Blood Flow to the Brain

oxygen brain lungs
If the flow of oxygen to the brain is disrupted, it can cause encephalopathy.
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Risk factors vary depending on type of encephalopathy. For example, alcohol use disorder puts you at risk for Wernicke’s encephalopathy or hepatic encephalopathy.

Symptoms    TOP

An altered mental state may include:

  • Sudden or progressive changes in memory
  • Inability to concentrate
  • Impaired thinking
  • Abnormal drowsiness
  • Mood changes
  • Progressive loss of consciousness
  • Subtle personality changes

Other symptoms may include:

  • Involuntary muscle twitches and flapping movements
  • Tremor
  • Muscle weakness and unsteadiness
  • Abnormal eye movements
  • Seizures

Signs that encephalopathy may be getting worse include:

  • Progressive confusion
  • Progressive drowsiness
  • Coma

Medical care is needed right away for these symptoms.

Diagnosis    TOP

Your doctor will ask you or your caregiver about your symptoms and medical history. A physical exam will be done.

To confirm diagnosis and determine the cause or extent of the encephalopathy, your doctor may request:

Treatment    TOP

The goal of treatment is to try to stop or reverse the damage by managing the condition causing the encephalopathy. Treatment is based on the cause, but may include:

  • Medications—to treat infections, manage related conditions like high blood pressure, remove toxins, and replace missing or low levels of vitamins or nutrients
  • Dietary changes—to improve nutrition or manage underlying condition
  • Dialysis—to clear harmful substances, like toxins, out of the blood
  • Organ transplant

Medical support may be needed through recovery including feeding tube or breathing support with severe encephalopathy.

Prevention    TOP

Many causes cannot be prevented. To help reduce the chance of encephalopathy:

  • Get early treatment for liver problems. If you have any of the above symptoms, call your doctor right away.
  • If you have a disease, see your doctor regularly.
  • Avoid overdosing on drugs, alcohol, or medications.
  • Avoid being exposed to poisons or toxins and infections or carriers of infections, such as mosquitoes.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Disorders
http://www.niddk.nih.gov
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Liver Foundation
http://www.liver.ca

References:

Cirrhosis complications: Encephalopathy. California Pacific Medical Center website. Available at:
...(Click grey area to select URL)
Updated November 14, 2014. Accessed February 12, 2016.
NINDS encephalopathy page. National Institute of Neurological Disorders and Stroke website. Available at:
...(Click grey area to select URL)
Updated November 9, 2010. Accessed February 12, 2016.
Last reviewed March 2017 by EBSCO Medical Review BoardRimas Lukas, MD
Last Updated: 2/12/2016

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