Leverencefalopathie

Leverencefalopathie, also known as hepatic encephalopathy, is a neuropsychiatric complication of severe liver dysfunction. It is characterized by a spectrum of cognitive, motor, and behavioral disturbances that arise when the liver is unable to adequately metabolize and detoxify substances that are normally cleared from the bloodstream. These toxic substances, primarily ammonia, accumulate in the circulation and cross the blood-brain barrier, interfering with normal brain function.

The onset of leverencefalopathie can be acute or chronic. Acute episodes are often precipitated by factors such as gastrointestinal bleeding, infection, dehydration, electrolyte imbalances, or the use of certain medications. Chronic leverencefalopathie may develop gradually and can be associated with conditions like cirrhosis. Symptoms can range from subtle changes in personality, sleep disturbances, and difficulty concentrating to more severe manifestations such as confusion, disorientation, asterixis (a flapping tremor of the hands), and even coma.

Diagnosis typically involves a combination of clinical assessment, blood tests to evaluate liver function and ammonia levels, and sometimes neuroimaging studies. The primary goal of treatment is to identify and address the underlying precipitating factors and reduce the production and absorption of toxins. This often includes dietary protein restriction, laxatives to promote ammonia excretion, and antibiotics to reduce intestinal bacteria that produce ammonia. Prognosis depends on the severity of the liver disease and the effectiveness of treatment.