Abstract
Introduction: Chronic liver disease and cirrhosis affect millions of patients all over the world. The vast majority of patients develop various complication related to portal hypertension. About 30-45% of patients with cirrhosis are known to suffer from hepatic encephalopathy. Hepatic encephalopathy (HE) is one recurrent complication, a reversible syndrome of impaired brain function, causes by a neurotoxin, impaired neurotransmission due to metabolic changed in liver failure, systemic inflammatory response, changed in brain energy metabolism and alteration in the blood-brain barrier. The manifests in a wide variety of neurological and psychiatric problems including personality changed, progressive disorientation in time and space, alterations in consciousness, stupor, and coma in the final stage. Treatment may include palliative therapies, correcting precipitating factors, lactulose or rifaximin.
The aim of Work: The study aims to give an overview of hepatic encephalopathy including the pathophysiology, etiological factors, diagnosis and treatment modalities.
Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: Chronic liver disease, hepatic encephalopathy, pathophysiology, management strategy
Conclusion: Cirrhosis and its complication remain as one of the major problems in the healthcare system all over the world. With the rapid spread of metabolic syndrome and non-alcoholic steatohepatitis induced cirrhosis, management of complications of cirrhosis has become more economically burdensome. Despite clinical trials and research, the pathogenesis of HE remains to be clarified more for more effective treatment options.