Hepatic Encephalopathy (Liver Failure Confusion)
Description
Confusion, agitation, and abnormal arm and leg movements caused by liver failure (cirrhosis). The disease is caused by the build up of toxic substances that are normally cleared by the liver. The disorder is triggered by dehydration, eating too much protein, blood chemistry problems, bleeding from the intestinal tract, infections, kidney failure, low oxygen levels, shunt placement or surgery.
Symptoms
Symptoms occur gradually and include confusion, change in behavior, personality changes, agitation, sleeping problems, abnormal movements of the arms and legs, seizures, slurred speech, and coma.
Tests
A history and physical exam will be done. A brain CT scan and/or MRI may be performed to rule out other causes of the symptoms. Blood tests including an ammonia level will also be done.
- CBC
- Chem 12
Treatment
Therapy is aimed at treating the triggering event as well as the hepatic encephalopathy. Patients should avoid eating high protein foods. Treatment includes causing diarrhea with medications such as lactulose and giving antibiotics orally such as neomycin.
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