Hepatic Encephalopathy: a Dynamic or Static Condition

Overview

Journal Metab Brain Dis

Publisher Springer

Specialties Endocrinology
Neurology

Date 2005 Sep 17

PMID 16167197

Citations 2

Authors

Charmaine A Stewart

Jane Cerhan

Affiliations

Soon will be listed here.

Abstract

Hepatic encephalopathy (HE) is a neuropsychiatric disorder associated with portal hypertension. The mechanism of this disorder is still being characterized and the management has relied primarily on lowering the amount of ammonia present in the gastrointestinal tract or reversing liver disease by replacing the diseased liver. It is, however, not established that all the effects of hepatic encephalopathy are reversed by liver transplantation. In this review, we have outlined the mechanisms underlying HE and the pros and cons of reversibility of HE.

Citing Articles

Portosystemic encephalopathy due to mesoiliac shunt in a patient without cirrhosis.

Ali S, Stolpen A, Schmidt W J Clin Gastroenterol. 2009; 44(5):381-3.

PMID: 19636259 PMC: 2858247. DOI: 10.1097/MCG.0b013e3181aae51b.

Delayed-onset hepatic encephalopathy induced by zolpidem: a case report.

Silva V, Bittencourt P, Pinho S, Cavalcanti A, Zollinger C Clinics (Sao Paulo). 2008; 63(4):565-6.

PMID: 18719775 PMC: 2664140. DOI: 10.1590/s1807-59322008000400028.

References

Rose C, Butterworth R, Zayed J, Normandin L, Todd K, Michalak A . Manganese deposition in basal ganglia structures results from both portal-systemic shunting and liver dysfunction. Gastroenterology. 1999; 117(3):640-4. DOI: 10.1016/s0016-5085(99)70457-9. View

Chan H, Butterworth R . Evidence for an astrocytic glutamate transporter deficit in hepatic encephalopathy. Neurochem Res. 1999; 24(11):1397-401. DOI: 10.1023/a:1022532623281. View

Rao K, Norenberg M . Manganese induces the mitochondrial permeability transition in cultured astrocytes. J Biol Chem. 2004; 279(31):32333-8. DOI: 10.1074/jbc.M402096200. View

Munoz M, Monfort P, Gaztelu J, Felipo V . Hyperammonemia impairs NMDA receptor-dependent long-term potentiation in the CA1 of rat hippocampus in vitro. Neurochem Res. 2000; 25(4):437-41. DOI: 10.1023/a:1007547622844. View

Al Mardini H, Harrison E, Ince P, Bartlett K, Record C . Brain indoles in human hepatic encephalopathy. Hepatology. 1993; 17(6):1033-40. View

Mattarozzi K, Stracciari A, Vignatelli L, DAlessandro R, Morelli M, Guarino M . Minimal hepatic encephalopathy: longitudinal effects of liver transplantation. Arch Neurol. 2004; 61(2):242-7. DOI: 10.1001/archneur.61.2.242. View

Sanyal A, FREEDMAN A, Luketic V, Purdum 3rd P, Shiffman M, Cole P . Transjugular intrahepatic portosystemic shunts compared with endoscopic sclerotherapy for the prevention of recurrent variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997; 126(11):849-57. DOI: 10.7326/0003-4819-126-11-199706010-00001. View

Schomerus H, Hamster W . Neuropsychological aspects of portal-systemic encephalopathy. Metab Brain Dis. 1999; 13(4):361-77. DOI: 10.1023/a:1020645110880. View

Schomerus H, Hamster W, Blunck H, Reinhard U, Mayer K, Dolle W . Latent portasystemic encephalopathy. I. Nature of cerebral functional defects and their effect on fitness to drive. Dig Dis Sci. 1981; 26(7):622-30. DOI: 10.1007/BF01367675. View

10.

Suarez I, Bodega G, Arilla E, Fernandez B . Long-term changes in glial fibrillary acidic protein and glutamine synthetase immunoreactivities in the supraoptic nucleus of portacaval shunted rats. Metab Brain Dis. 1996; 11(4):369-79. DOI: 10.1007/BF02029497. View

11.

Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei A . Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002; 35(3):716-21. DOI: 10.1053/jhep.2002.31250. View

12.

Nolte W, Wiltfang J, Schindler C, Munke H, Unterberg K, Zumhasch U . Portosystemic hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: clinical, laboratory, psychometric, and electroencephalographic investigations. Hepatology. 1998; 28(5):1215-25. DOI: 10.1002/hep.510280508. View

13.

Schomerus H, Hamster W . Quality of life in cirrhotics with minimal hepatic encephalopathy. Metab Brain Dis. 2001; 16(1-2):37-41. DOI: 10.1023/a:1011610427843. View

14.

Guerrini V . Effect of antioxidants on ammonia induced CNS-renal pathobiology in sheep. Free Radic Res. 1994; 21(1):35-43. DOI: 10.3109/10715769409056553. View

15.

Mechtcheriakov S, Graziadei I, Mattedi M, Bodner T, Kugener A, Hinterhuber H . Incomplete improvement of visuo-motor deficits in patients with minimal hepatic encephalopathy after liver transplantation. Liver Transpl. 2004; 10(1):77-83. DOI: 10.1002/lt.20009. View

16.

Jayakumar A, Panickar K, Norenberg M . Effects on free radical generation by ligands of the peripheral benzodiazepine receptor in cultured neural cells. J Neurochem. 2002; 83(5):1226-34. DOI: 10.1046/j.1471-4159.2002.01261.x. View

17.

Ratcliffe J, Longworth L, Young T, Bryan S, Burroughs A, Buxton M . Assessing health-related quality of life pre- and post-liver transplantation: a prospective multicenter study. Liver Transpl. 2002; 8(3):263-70. DOI: 10.1053/jlts.2002.31345. View

18.

Young S, Lal S . CNS tryptamine metabolism in hepatic coma. J Neural Transm. 1980; 47(3):153-61. DOI: 10.1007/BF01250597. View

19.

Aguilar M, Minarro J, Felipo V . Chronic moderate hyperammonemia impairs active and passive avoidance behavior and conditional discrimination learning in rats. Exp Neurol. 2000; 161(2):704-13. DOI: 10.1006/exnr.1999.7299. View

20.

Tarter R, Switala J, Arria A, Plail J, Van Thiel D . Subclinical hepatic encephalopathy. Comparison before and after orthotopic liver transplantation. Transplantation. 1990; 50(4):632-7. View