Hepatic Encephalopathy





Hepatic encephalopathy (sometimes referred to as HE or portal-systemic encephalopathy) is the loss of normal brain function in relation to, or as a result of, liver failure. It is a serious condition that, if left unmanaged or untreated, can result to coma or even death, due to the accumulation of harmful toxins in the bloodstream.

It occurs in about 300 to 500 for every 1,000 patients with cirrhosis. This type of condition may ensue at any age; however it can peak during the 50s or the 60s. Hepatic encephalopathy uniformly affects both genders.

This condition significantly affects the mental capacity and functions of an individual, thus debilitating him or her.A patient suffering from this condition generally is unable to take care of their personal needs.



There is no known cause for hepatic encephalopathy. It is, however, brought about by conditions that affect the normal functioning of the liver. When there is liver failure, the toxins that are supposed to be taken out from the bloodstream tend to buildup and wreak havoc on the patient’s brain.

Hepatic encephalopathy is somehow associated with chronic liver diseases such as hepatitis and cirrhosis; including those conditions that, by some means, limits the blood circulation in the liver. This condition may also be set off by the following:

  • Systemic infections;
  • Dehydration;
  • High consumption of protein;
  • Electrolyte irregularities, especially when potassium is decreased after episodes of vomiting or intake of diuretics;
  • Oxygen levels that are low;
  • Surgery;
  • Use on immunosuppressant medications;
  • Use of medications that are CNS depressants like tranquilizers and barbiturates; and
  • Internal bleeding (such as in the esophagus, stomach or intestines).

This condition can either be a chronic problem resulting from a serious liver disease, or it can be a short-term crisis that can be managed with the proper treatment.


Signs and Symptoms

The manifestations of hepatic encephalopathy may vary depending on the type or cause of the liver damage. Signs and symptoms can also be categorized depending on the seriousness of the loss in brain function.

During the early stages of the disease, it may manifest the following symptoms:

  • Changes in sleeping patterns;
  • Mild confusion;
  • Changes in the thinking processes;
  • Personality changes or mood swings;
  • Having trouble concentrating or making decisions;
  • Increased incidence of forgetfulness; and
  • Loss of or decrease in ability to do fine motor skills such as handwriting and personal care tasks.

Once the condition becomes more severe, symptoms may now include:

  • Gross disorientation;
  • Confusion;
  • Serious personality changes and strange behavior;
  • Anxiety and fatigue;
  • Agitation or excitement that can end up in seizures (rare occurrence);
  • Unusual hand/arm movements such as shaking;
  • Slow, listless movement (of the body); and
  • Slurred or garbled speech.

If severe hepatic encephalopathy is left untreated, the condition can result to unresponsiveness and unconsciousness that can possibly lead to coma.



The treatment for hepatic encephalopathy has the following main objectives: delivery of supportive care; identification and elimination of causative agents and precipitating factors; and reduction of nitrogen and ammonia content in the body. The treatment options then differ according to the severity of the condition.

One route taken in the management of hepatic encephalopathy is the dietary approach, wherein the intake of protein is lessened to an adequate tolerable amount to avoid exacerbating the symptoms of the condition. The intake of prebiotics and probiotics is also encouraged to promote growth of helpful intestinal flora that can aid in the elimination of the unwanted toxins.

For severe cases of hepatic encephalopathy, hospitalization with critical care treatment is a must. Intubation is often necessary to avoid life-threatening complications and to allow a safer method of delivering treatment medication and parenteral nutrition to the patient. Oxygen therapy is also utilized to alleviate respiratory symptoms.


Disability Tax Credits for Hepatic Encephalopathy

Hepatic encephalopathy affects your cognition, thus hindering you from performing your usual activities of daily living. If you or someone you know has been suffering from this condition, you may be entitled to a disability tax credit from the Canadian Revenue Agency. All you have to do is to secure a disability tax certificate from your qualified health practitioner and then place a call to the HandyTax hotline. Our friendly customer service representatives are more than willing to assist you in filing your claims regarding your disability tax refunds.