21. 1Up Health > Hepatic Encephalopathy (Encephalopathy - Hepatic, Hepatic Coma) Inf Comprehesive information on hepatic encephalopathy (Encephalopathy hepatic,Hepatic coma). 1Up Health Diseases Conditions hepatic encephalopathy. http://www.1uphealth.com/health/hepatic_encephalopathy.html

1Up Health Alternative Medicine Clinical Trials Health News ... Health Topics A-Z Search 1Up Health Hepatic encephalopathy Information Guide Alternative names : Encephalopathy - hepatic, Hepatic coma Definition : A group of symptoms that may occur when there is damage to the brain and nervous system as a complication of liver disorders, characterized by various neurologic symptoms including changes in reflexes, changes in consciousness , and behavior changes that can range from mild to severe. Jump to a Section of this Guide Definition Causes, Incidence, and Risk Factors Symptoms Prevention ... Calling your Health Care Provider Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com: Acute renal failure Alcohol withdrawal Alcoholism Alkalosis ... More More Topics Acute Agitation Ammonia Behavior - unusual or strange ... More Search 1Up Health A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s

22. CMRRC Hepatic Encephalopathy Publications hepatic encephalopathy Proton MR spectroscopic measurement of neurometabolitesin hepatic encephalopathy during oral lactulose therapy . http://cnid.unm.edu/publications/he.html

Hepatic Encephalopathy " Proton MR spectroscopic measurement of neurometabolites in hepatic encephalopathy during oral lactulose therapy". Haseler LJ, Sibbitt Jr WL, Mojtahedzadeh HN, Reddy S, Agarwal VP, and McCarthy DM. Am J Neuroradiol, Abstract Background and Purpose: MR imaging and MR spectroscopy are increasingly being used to determine response to pharmacologic therapy. Hepatic encephalopathy (HE) is characterized by abnormal cerebral metabolites, yet the response to lactulose and other anti-HE measures is still primarily determined using arbitrary categorical clinical rating scales, rather than MR spectroscopy. The purpose of this study was to determine whether MR spectroscopy could demonstrate relevant neurometabolite changes associated with lactulose therapy and thereby provide further support for the use of MR spectroscopy in clinical trials. Methods: Ten controls and 23 patients with grades I-III HE were studied by proton MR spectroscopy (TE/TR = 26/2000). Metabolite ratios were calculated for myo-inositol/creatine (mIn/Cre), choline/creatine (Cho/Cre), (glutamine+glutamate)/creatine (Glx/Cre), N-acetylaspartic acid/creatine (NAA/Cre), and (Cho+mIn)/Glx. A time series design trial was used in which HE patients were compared before and after lactulose therapy (60 cc by mouth three times per day). Results: Relative to controls, HE was characterized 43%, 64%, and 5% reductions, respectively, in mIn/Cre (p=0.00002), (Cho+mIn)/Glx (p=0.00003), and Cho/Cre (p=0.45). In contrast, Glx/Cre was increased by 75% (p=0.00003), and NAA/Cre was not changed (p=0.33). Therapy with lactulose was associated with increases of 29%, 37%, and 7%, respectively, in mIn/Cre (p=0.03), (Cho+mIn)/Glx (p=0.03), and Cho/Cre (p=0.31) as well as respective decreases of 15% and 42% in Glx/Cre (p=0.14) and HE Grade (p=0.14). NAA/Cre did not change with lactulose therapy (p=0.93).

23. Hepatic Encephalopathy In Dogs hepatic encephalopathy in Dogs hepatic encephalopathy Followup on HepaticEncephalopathy also see Neurological Problems also see Liver problems. http://www.vetinfo.com/dhepaticenceph.html

Please note: The information on our site is for everyone to read.Please use it as often as you like. However, Ask Dr Mike is available only to subscribers of our Vetinfo Digest. Please do not send questions if you are not a subscriber. Please use the search engine or one of the indexes to see if the information you need is already online. Please see Subscriber info for details. Subscriber Info The income from the subscriptions helps defray the cost of maintaining the site and allows us to keep the large amount of information on www.vetinfo.com free to our readers. Hepatic Encephalopathy in Dogs Hepatic Encephalopathy Followup on Hepatic Encephalopathy also see Neurological Problems also see Liver problems Hepatic Encephalopathy Q: Where can I find out more about hepatic encephalopathy? I am interested in what you find regarding Trixie's (my poodle) holding her neck and head extended. Have you seen this symptom in any patient? She can't control her head moments very well to drink or eat properly.

24. Hepatitis C Vets, Hepatic Encephalopathy, Hepatic, Hepatic Coma, What Is It? hepatic encephalopathy Alternative Causes, incidence, and risk factors Hepaticencephalopathy is caused by disorders affecting the liver. These http://hepcvets.com/what/hepaticenceph.html

What's New? Our Latest Additions Hepatitis C Books On Liver Disease (Recommended) Clinical Trials Depression Drugs Used In Treatment Fibrosis/Cirrhosis Genotypes Hepatitis B HEPC INFO Only List Sign Up HEPC INFO Only Full Text Medical Articles Herbs/Alternative Medicine Insurance Issues Liver Disease Glossary Miscellaneous Vaccine Information Veterans Table Of Contents Viral Loads What The Heck Is....VERY INFORMATIVE 2002 NIH Hepatitis C Consensus Hep C Vets Bulletin Board Hepatitis C Bulletin Board Our Favorite Links Poetry/Short Stories Hepatic Encephalopathy Alternative names: hepatic coma; encephalopathy - hepatic Definition: A group of symptoms that may occur when there is damage to the brain and nervous system as a complication of liver disorders, characterized by various neurologic symptoms including changes in consciousness, behavior changes, and personality changes. Causes, incidence, and risk factors: Hepatic encephalopathy is caused by disorders affecting the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis) and conditions where blood circulation bypasses the liver. The exact cause of the disorder is unknown. The liver cannot properly metabolize and detoxify substances in the body. Accumulation of toxic substances causes metabolic abnormalities that lead to damage in the central nervous system (brain and spinal cord). The most common toxic substance is ammonia, which is produced by the body when proteins are digested, but normally is detoxified by the liver. Many other substances also accumulate in the body and damage the nervous system.

25. Hep C Vets, Hepatic Encephalopathy hepatic encephalopathy. AbouAssi S, Vlahcevic R. hepatic encephalopathy metabolicconsequence of cirrhosis often is reversible. Postgrad Med 2001;109(2)52-70. http://hepcvets.com/se/enceph.html

Hepatitis C Hepatitis B 2002 NIH Hepatitis C Consensus HEPC INFO Only List Sign Up HEPC INFO Only Full Text Drugs Used In Treatment Fibrosis/Cirrhosis Genotypes Books On Liver Disease (Recommended) Herbs/Alternative Medicine Insurance Issues Liver Disease Glossary Vaccine Information Viral Loads Veterans Table Of Contents Poetry/Short Stories Hep C Vets Bulletin Board Hepatitis C Home Bulletin Board Biological Warfare Online Hepatitis Chats/Support Miscellaneous Hepatic encephalopathy Metabolic consequence of cirrhosis often is reversible Souheil Abou-Assi, MD; Z. Reno Vlahcevic, MD* VOL 109 / NO 2 / FEBRUARY 2001 / POSTGRADUATE MEDICINE CME learning objectives To understand the pathogenesis of hepatic encephalopathy in chronic liver disease To recognize the clinical manifestations and diagnostic tools used to detect hepatic encephalopathy To be aware of the precipitating factors for hepatic encephalopathy and to try to avoid them in patients with cirrhosis The authors disclose no financial interests in this article. Supported by a grant from the National Institutes of Health and a grant from the Department of Veterans Affairs.

26. Ambazonia Indymedia | Hepatic Encephalopathy | 04.01.2003 21:35 top navigation article, hepatic encephalopathy. Author GPnotebook.co.uk 04.01.2003 2135. Hepatic hepatic encephalopathy. Hepatic http://ambazonia.indymedia.org/en/2003/01/142.shtml

deutsch english francais top ... article Topics IMC Ambazonia Print Radio ecology ... politics Indymedia Network www.indymedia.org IMC Process process discussion tech volunteer ... legal updates Projects climate print radio satellite tv ... video Pacific adelaide aotearoa brisbane jakarta ... sydney Africa nigeria south africa Europe athens austria barcelona belgium ... united kingdom Canada alberta hamilton maritimes montreal ... windsor Latin America argentina bolivia brasil chiapas ... uruguay South Asia india mumbai West Asia israel palestine United States arizona atlanta austin baltimore ... article hepatic encephalopathy Hepatic encephalopathy is a metabolic disorder of the central nervous system and neuromuscular system that may complicate liver failure from any cause http://www.gpnotebook.co.uk/simplepage.cfm?ID=2033516561" http://www.gpnotebook.co.uk/logo.gif" border="0" width="150" height="40"> Welcome to GPnotebook. For full access to the site please read our terms and conditions by clicking on a hyperlink. http://www.gpnotebook.co.uk/simplepage.cfm?ID=2033516561" http://www.gpnotebook.co.uk/homeup.gif" border="0" name="home" width="69" height="29"> http://www.gpnotebook.co.uk/backup.gif"

27. ??content.title.prefix?? | Hepatic Encephalopathy | 04.01.2003 21:35 top navigation article, hepatic encephalopathy. article.author GPnotebook.co.uk 04.01.2003 2135. Hepatic hepatic encephalopathy. Hepatic http://ambazonia.indymedia.org/fr/2003/01/142.shtml

deutsch english francais top ... article general.topics IMC Ambazonia Print Radio ecology ... politics Indymedia Network www.indymedia.org IMC Process process discussion tech volunteer ... legal updates Projects climate print radio satellite tv ... video Pacific adelaide aotearoa brisbane jakarta ... sydney Africa nigeria south africa Europe athens austria barcelona belgium ... united kingdom Canada alberta hamilton maritimes montreal ... windsor Latin America argentina bolivia brasil chiapas ... uruguay South Asia india mumbai West Asia israel palestine United States arizona atlanta austin baltimore ... article hepatic encephalopathy Hepatic encephalopathy is a metabolic disorder of the central nervous system and neuromuscular system that may complicate liver failure from any cause http://www.gpnotebook.co.uk/simplepage.cfm?ID=2033516561" http://www.gpnotebook.co.uk/logo.gif" border="0" width="150" height="40"> Welcome to GPnotebook. For full access to the site please read our terms and conditions by clicking on a hyperlink. http://www.gpnotebook.co.uk/simplepage.cfm?ID=2033516561" http://www.gpnotebook.co.uk/homeup.gif" border="0" name="home" width="69" height="29"> http://www.gpnotebook.co.uk/backup.gif"

28. All-Net Fulminant Hepatic Failure Hepatic Encephalopathy Fulminant hepatic failure /hepatic encephalopathy edema. hepatic encephalopathyand cerebral edema can complicate acute liver failure. http://www.med.ub.es/All-Net/english/gipage/liver/fhf-15.htm

29. All-Net Fulminant Hepatic Failure Hepatic Encephalopathy Longwood Avenue, Boston, Massachusetts USA. Fulminant hepatic failure/hepatic encephalopathy edema. The coagulopathy of FHF is http://www.med.ub.es/All-Net/english/gipage/liver/fhf-17.htm

30. Benzodiazepine Receptor Antagonists For Acute And Chronic Hepatic Encephalopathy Benzodiazepine receptor antagonists for acute and chronic hepatic encephalopathy(Cochrane Review). AlsNielsen B, Kjaergard LL, Gluud C. ABSTRACT http://www.cochrane.org/cochrane/revabstr/ab002798.htm

Abstract from The Cochrane Library , Issue 1, 2003 Click here to order the full review Benzodiazepine receptor antagonists for acute and chronic hepatic encephalopathy (Cochrane Review) Als-Nielsen B, Kjaergard LL, Gluud C ABSTRACT A substantive amendment to this systematic review was last made on 10 July 2001. Cochrane reviews are regularly checked and updated if necessary. Background: The pathogenesis of hepatic encephalopathy is unknown. It has been suggested that liver failure leads to the accumulation of substances that bind to a receptor-complex in the brain resulting in neural inhibition which may progress to coma. Several trials have assessed benzodiazepine receptor antagonists for hepatic encephalopathy, but the results are conflicting. Objectives: To evaluate the efficacy and safety of benzodiazepine receptor antagonists for patients with acute or chronic hepatic encephalopathy. Search strategy: Eligible trials were identified through The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Controlled Trials Register on The Cochrane Library (Issue 2, 2001), MEDLINE and EMBASE (last searched: June 2001), reference lists of relevant articles, authors of trials, and the pharmaceutical company known to produce benzodiazepine receptor antagonists. Selection criteria: Randomised trials comparing any benzodiazepine receptor antagonist versus placebo or no intervention for hepatic encephalopathy were included, regardless of language or publication status.

31. Hepatic Encephalopathy hepatic encephalopathy. By Liz Highleyman. Print this page. Encephalopathyis a general by people with HCV. Causes of hepatic encephalopathy. http://www.hcvadvocate.org/hepatic_encephalopathy.htm

Hepatic Encephalopathy By Liz Highleyman Print this page Causes of Hepatic Encephalopathy The liver carries out many important bodily functions including filtering toxic metabolic byproducts from the blood. Normally blood coming from the intestines flows through the liver, where it undergoes detoxification. In people with decompensated cirrhosis—when the damaged liver is unable to carry out its normal metabolic processes or when blood bypasses the liver—these toxins can build up in the bloodstream. Blood may bypass or be shunted around the liver when blood flow through the liver is blocked by scar tissue (causing portal hypertension) or when an artificial shunt is surgically inserted (a procedure sometimes done to control bleeding varices or ascites). High levels of toxins can affect the central nervous system (the brain and spinal cord), although how they do so is not well understood. Increased levels of ammonia are believed to be most responsible for hepatic encephalopathy. Ammonia is a byproduct of the digestion of proteins by bacteria in the intestines; normally ammonia is metabolized into urea by the liver and excreted by the kidneys as urine. High levels of ammonia appear to alter the balance of neurotransmitters (chemicals that carry messages between neurons) in the brain . This theory is supported by the fact that reducing ammonia usually improves encephalopathy symptoms; however, some people with hepatic encephalopathy do not have elevated blood ammonia levels.

32. Hepatic Encephalopathy hepatic encephalopathy. Definition Causes, incidence, and risk factorshepatic encephalopathy is caused by disorders affecting the liver. http://www.pennhealth.com/ency/article/000302.htm

Disease Injury Nutrition Poison ... Prevention Hepatic encephalopathy Definition: A group of symptoms that may occur when there is damage to the brain and nervous system as a complication of liver disorders, characterized by various neurologic symptoms including changes in reflexes, changes in consciousness , and behavior changes that can range from mild to severe. Alternative Names: Hepatic coma; Encephalopathy - hepatic Causes, incidence, and risk factors: Hepatic encephalopathy is caused by disorders affecting the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis ) and conditions where blood circulation bypasses the liver. The exact cause of the disorder is unknown. The liver cannot properly metabolize and detoxify substances in the body. Accumulation of toxic substances causes metabolic abnormalities that lead to damage in the central nervous system (brain and spinal cord). One substance believed to be toxic is ammonia , which is produced by the body when proteins are digested, but normally is detoxified by the liver. Many other substances also accumulate in the body and damage the nervous system.

33. Hepatic Encephalopathy hepatic encephalopathy. Alternative Names Treatment hepatic encephalopathyis an acute medical condition that may become a medical emergency. http://www.pennhealth.com/ency/article/000302trt.htm

Disease Injury Nutrition Poison ... Prevention Hepatic encephalopathy Alternative Names: Hepatic coma; Encephalopathy - hepatic Treatment: Hepatic encephalopathy is an acute medical condition that may become a medical emergency. Hospitalization is required. The goals of treatment include life support, elimination or treatment of precipitating factors, and removal or neutralization of ammonia and other toxins . Life support including support of breathing or circulation may be required, particularly if coma develops. Cerebral edema (brain swelling ) may occur and may be life-threatening. Precipitating factors must be identified and treated. Gastrointestinal bleeding must be stopped. The intestines must be emptied of blood. Blood breaks down into protein components that are converted to ammonia. Treatment of infections, renal failure, and electrolyte abnormalities (especially potassium) are important. The patient should reduce or eliminate protein in diet to reduce ammonia production. Vegetable protein may be tolerated better than animal protein. Specially formulated intravenous or tube feedings may be necessary.

34. Member Sign In Liver Dialysis Appears Effective for Refractory hepatic encephalopathy.Neil Osterweil. Nov. 2, 2002 (Boston) — Patients with episodic http://www.medscape.com/viewarticle/443936

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35. Member Sign In What is the probable reason and treatment for hepatic encephalopathyin an HCVpositive kidney transplant recipient? Focus On http://www.medscape.com/viewarticle/438530

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36. Hepatic Encephalophaty The typical symptoms of hepatic encephalopathy include. · impaired consciousness(drowsiness),. The typical symptoms of hepatic encephalopathy include. http://home3.inet.tele.dk/omni/encephalopathy.htm

The Danish Hepatitis C website Hepatic encephalopathy (for patients and relatives): The typical symptoms of hepatic encephalopathy include The typical symptoms of hepatic encephalopathy include ... Ascites Hepatic encephalopathy (for patients and relatives): Hepatic encephalopathy refers to the changes in the brain that occur in patients with advanced acute or chronic liver disease. If liver cells are damaged, certain substances that are normally cleansed from the blood by the healthy liver are not removed (ammonia mainly, and other toxins). A patient with chronic hepatic encephalopathy may develop progressive loss of memory, disorientation, untidiness, and muscular tremors, leading to a form of chronic dementia. The ingestion of protein invariably aggravates these symptoms. The treatment of hepatic encephalopathy involves, first, the removal of all drugs that require detoxification in the liver and, second, the reduction of the intake of protein. Restricting the amount of protein in the diet will generally lower the levels of amino acids and ammonia in the bloodstream and brain. Most physicians advise their patients with this condition to eat only about 40 grams of protein a day, and will prescribe lactulose or neomycin to lower amino acid production. Non-meat proteins, such as those found in vegetables and milk, are preferred. Certain amino acids are used in treatment, since they are considered less likely to cause mental impairment. A dietary supplement rich in these amino acids is used at many liver treatment centers.

37. Cirrhosis And Its Effect Hepatic Encephalopaty The typical symptoms of hepatic encephalopathy include. · impaired consciousness(drowsiness),. · monotonous speech,. Treatment of hepatic encephalopathy. http://home3.inet.tele.dk/omni/cirrhosis2.htm

The Danish Hepatitis C website Cirrhosis of the liver and its effect (No. 2) – Hepatic encephalopathy The following explains why you should avoid protein in your diet and why you should avoid drugs which causes the liver to filter them out: Contents: 1. Cirrhosis of the liver and its effects 1a. Ascites 1b. Oesophagael Varices 1b.1. Sclerotherapy Versus Banding for Variceal Bleeding ... 1c. Hepatic encephalopaty Cirrhosis of the liver and its effects Chronic Hepatitis C (CHC) is one of the diseases that may lead to cirrhosis of the liver (the normal liver cells are irreversibly replaced by scar tissue). The loss of normal liver tissue increasingly slows the processing of nutrients, hormones, drugs, and toxins by the liver, as well as the production of proteins and other substances made by the liver. The scar tissue that forms in cirrhosis damages the structure of the liver, progressively making the flow of blood through the liver more difficult. People with liver cirrhosis may develop other complications: When the liver is heavily scarred, the blood cannot get through the liver at the normal pace because of the obstruction presented by the scar tissue, thus creating a higher than normal pressure in the portal vein - the main vein feeding the liver (portal hypertension).

38. Virtual Hospital: University Of Iowa Family Practice Handbook, Fourth Edition: G University of Iowa Family Practice Handbook, Fourth Edition, Chapter5. Gastroenterology And Hepatology hepatic encephalopathy. Jatinder http://www.vh.org/adult/provider/familymedicine/FPHandbook/Chapter05/20-5.html

For Providers University of Iowa Family Practice Handbook, Fourth Edition, Chapter 5 Gastroenterology And Hepatology: Hepatic Encephalopathy Jatinder P. S. Ahluwalia, MD, Mark A. Graber, MD, and William B. Silverman, MD Division of Gastroenterlogy and Hepatology and Departments of Internal Medicine, Family Medicine, and Emergency Medicine University of Iowa Hospitals and Clinics and College of Medicine Peer Review Status: Externally Peer Reviewed by Mosby General Information . Hepatic encephalopathy (HE) is a reversible metabolic encephalopathy with global central nervous system depression that occurs as a result of hepatocellular failure. Associated with increased portosystemic shunting of nitrogenous compounds derived from the gut. Precipitated or exacerbated by GI hemorrhage, excess dietary protein, constipation, infection (SBP), hypokalemia, and systemic alkalosis. Ammonia is thought to play an important role in the pathogenesis of HE, but its plasma level correlates poorly with the severity of HE. Manifestation and evaluation Its clinical presentation ranges from subtle changes in behavior and sleep inversion to deep coma.

39. Hepatic Encephalopathy Common Precipitants Of hepatic encephalopathy. Increased Nitrogen Load. Gastrointestinalbleeding. Clinical Stages Of hepatic encephalopathy. Stage. Mental Status. http://www.geocities.com/twisted_artist/Medecine/hepatic_encephalopathy.htm

Hepatic Encephalopathy DEFINITION: Hepatic encephalopathy is a syndrome seen in patients with cirrhosis of the liver. It is characterized by personality changes, intellectual impairment, and a depressed level of consciousness , fluctuating neurologic signs, asterixis or "flapping tremor," and distinctive electroencephalographic changes. An important prerequisite for the syndrome is diversion of portal blood into the systemic circulation through porto-systemic collateral vessels. Indeed, hepatic encephalopathy may develop in non-cirrhotic patients who have undergone portocaval shunt surgery. The development of hepatic encephalopathy is explained to some extent by the effect of neurotoxic substances, which occurs in the setting of cirrhosis and portal hypertension. Subtle signs of hepatic encephalopathy are seen in nearly 70% of patients with cirrhosis. Symptoms may be debilitating in a significant number of patients and are seen in 24-53% of patients who undergo portosystemic shunt surgery. About 30% patients dying of end-stage liver disease will experience significant encephalopathy, approaching coma. Encephalopathy may be acute and reversible or chronic and progressive . In severe cases, irreversible coma and death may occur. Acute episodes may recur with variable frequency

40. Hepatic Encephalopathy hepatic encephalopathy Definition A neuropsychiatric disorder caused dt liverdisease. Commonly seen in cirrhosis in acute fulminant liver failure. http://www.geocities.com/hotsprings/villa/6315/lessons/mednotes/hepaticencephalo

HEPATIC ENCEPHALOPATHY Definition - A neuropsychiatric disorder caused d.t. liver disease. Aetiology - Chronic liver cell failure - cirrhosis Acute fulminant liver failure Precipitating factors - Uraemia Fluid depletion states e.g. rapid tapping of ascites without adequate circulatory support Hypokalemia Infection Trauma - including surgery Excess protein intake Bleeding into GIT Constipation Portasystemic shunts with a hypo-functioning liver e.g. in a Child's grade C. Will not cause encephalopathy if liver is normal. Drugs - sedatives, anti-depressants Pathogenesis - Substances involved may be ammonia, GABA, octopamine, mercaptans, amino acids, fatty acids. Benzodiazepin receptors may play a role in the pathogenesis - alter GABA permeability - Flumazenil is being used in treatment of hepatic coma. C/F - May be convulsions. Earliest symptom - disturbance in sleep pattern Earliest sign - constructional apraxia Loss of higher functions - unable to perform simple arithmetic, or drawing simple figures.

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