Elsevier

Journal of Hepatology

Volume 73, Issue 6, December 2020, Pages 1526-1547
Journal of Hepatology

Seminar
Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy

https://doi.org/10.1016/j.jhep.2020.07.013Get rights and content

Summary

Hepatic encephalopathy (HE) is a frequent and serious complication of both chronic liver disease and acute liver failure. HE manifests as a wide spectrum of neuropsychiatric abnormalities, from subclinical changes (mild cognitive impairment) to marked disorientation, confusion and coma. The clinical and economic burden of HE is considerable, and it contributes greatly to impaired quality of life, morbidity and mortality. This review will critically discuss the latest classification of HE, as well as the pathogenesis and pathophysiological pathways underlying the neurological decline in patients with end-stage liver disease. In addition, management strategies, diagnostic approaches, currently available therapeutic options and novel treatment strategies are discussed.

Keywords

Hepatic encephalopathy
Treatments
Pathogenesis
Pathophysiology
Ammonia
Management
Diagnosis

Cited by (0)

View Abstract