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Hepatic encephalopathy: a neurologist’s perspective
  1. Edward Needham1,2,
  2. Gwilym Webb3
  1. 1Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
  2. 2Department of Neurology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  3. 3Department of Hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Edward Needham, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK; edneedham{at}doctors.org.uk

Abstract

Liver disease is increasingly common, estimated to affect over 25% of the world’s population. Failure of the liver to maintain a normal metabolic milieu leads to impaired brain function (hepatic encephalopathy), and conditions that cause liver disease can themselves predispose to neurological disease. As neurologists’ involvement with the acute take increases, it is important that we are familiar with the neurological complications of liver disease, their investigation and management, and to know which other neurological diseases occur in this patient population. In this article, we review the causes, presentation and treatment of hepatic encephalopathy, and discuss important differential diagnoses in patients with liver disease who present with neurological disturbance.

  • GASTROENTEROLOGY
  • LIVER DISEASE
  • COMA
  • INTENSIVE CARE

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Footnotes

  • Twitter @needhamneuro

  • Contributors EN and GW contributed equally to the design and drafting of this manuscript.

  • Funding EN receives funding from Brain Research UK.

  • Competing interests None declared.

  • Provenance and peer review Commissioned. Externally peer reviewed by Neil Anderson, Auckland, New Zealand.