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(Encephalopathy, Hepatic; Portal-Systemic Encephalopathy; Encephalopathy, Portal-Systemic)
Pronounced: HEP-at-ik En-SEF-a-lo-PATH-ee
by Nathalie Smith, MSN, RN
Hepatic encephalopathy is a problem with the brain that is caused by liver disease. The problem may be temporary or permanent.
A liver with disease cannot filter the harmful items in blood. These toxins build up in the blood, which reaches the brain and affects the brain’s ability to work properly.
Risk Factors TOP
Factors that increase your chance of hepatic encephalopathy include:
In the early stages, you may not notice any symptoms. As the condition progresses, symptoms may include:
If you have liver problems and any of the above symptoms, call your doctor right away.
You will be asked about your symptoms and medical history. A physical exam will be done. The condition of your nervous system will also be assessed.
Your liver and kidney function may be assessed. This can be done with:
Your brain and nervous system may be assessed. This can be done with:
Hospitalization and Emergency Care
The initial treatment will focus on treating and trying to reverse the underlying problems. If possible, toxins in your blood will be removed or neutralized.
Medications may be used to:
Dietary Restrictions TOP
Changes in your diet may be recommended. Tube feeding may be needed to supply nutrients, especially in the case of coma.
To help reduce your chance of hepatic encephalopathy:
National Digestive Diseases Information Clearinghouse
National Institute of Neurological Disorders and Stroke
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4/2/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: FDA approves new use of Xifaxan for patients with liver disease. US Food and Drug Administration website. Available at:
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Updated April 24, 2013. Accessed February 17, 2014.
Last reviewed February 2018 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 3/5/2014
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