Hepatic encephalopathy symptoms can vary from person to person. However, some common signs and symptoms include:
Changes in sleeping habits or routine, such as going to bed earlier than usual, changing sleep patterns and waking up very early; reduced attention span and concentration; memory loss; changes in personality and thinking; mood elevation and depression; changes in behavior; and loss of consciousness (coma). In severe cases, HE can be life-threatening.
HE usually develops after a period of severe liver damage or liver disease. It’s also seen in people with cirrhosis, which is scarring of the liver that affects its ability to filter toxins and other substances from the bloodstream.
The HE symptoms can come on rapidly or slowly, and they can start in one part of the body and then spread to another. The symptoms can be very painful and uncomfortable.
Your doctor may prescribe a medication called an antidote that can help stop the spread of HE. This treatment is given by mouth, and it can be very effective for some people.
If you have hepatic encephalopathy, you should avoid drinking alcohol. It can increase the levels of toxins in your bloodstream and cause other problems, such as heart problems and strokes.
You should also drink a lot of water, and get plenty of rest. Exercise, such as walking, swimming or gardening, can be helpful for lowering the levels of toxins in your body and improving brain function.
When HE is treated properly, most people will recover from it. But some people can have it for years or even a lifetime and have problems with their mental health.
There are three types of HE: Type A, B and C. Type A is brought on by acute liver failure, without underlying chronic liver disease; type B occurs in some people who have a shunt that connects two veins inside the liver (transjugular intrahepatic portosystemic shunt or TIPS); and type C is caused by cirrhosis, which is scarring and damaged tissue in the liver that prevents it from working well.
HE can be triggered by dehydration, infection and some medications. Your doctor will need to monitor your condition closely and make sure you get the right treatment for it.
Your doctor will probably test your urine for hepatic toxins. He may also want to take your blood for a test. This will check the levels of bilirubin, ammonia and other chemicals that can cause hepatic encephalopathy.
The blood tests will also help your doctor identify if you have any other conditions that can cause hepatic encephalopathy. Some people can have multiple problems that lead to hepatic encephalopathy, such as a hepatitis B or C infection or an overgrowth of bacteria in the stomach, intestines, or colon.
You should ask your doctor about the hepatic encephalopathy testing that is available, such as electroencephalogram (EEG). This may be helpful in determining whether seizures are present.
