• Encephalopathy

    (Glycine Encephalopathy; Hepatic Encephalopathy; Hypoxic Encephalopathy; Statin Encephalopathy; Uremic Encephalopathy; Wernicke’s Encephalopathy; Hashimoto’s Encephalopathy; Hypertensive Encephalopathy; Toxic-metabolic Encephalopathy)

    Definition

    This is a general term for a disease that alters a person’s brain function and mental state. Some types of encephalopathy include:
    • Glycine encephalopathy—caused by a metabolic disorder (how the cells make energy)
    • Hepatic encephalopathy —caused by liver disease
    • Hypoxic encephalopathy —caused by reduced oxygen to brain
    • Static encephalopathy—permanent brain damage
    • Uremic encephalopathy—caused by toxins remaining in the body
    • Wernicke’s encephalopathy—caused by a thiamine deficiency, usually due to alcoholism
    • Hashimoto’s encephalopathy—an autoimmune disorder (when your immune system attacks your body’s cells)
    • Hypertensive encephalopathy—caused by very high blood pressure
    • Toxic-Metabolic encephalopathy—a general term to describe encephalopathies caused by infections, toxins, or organ failure
    Treating the cause can reverse symptoms. But, some forms of may result in lasting changes in the brain. If brain injury is severe and cannot be reversed, the disease can be fatal.

    Causes

    The cause depends on the type of encephalopathy. Causes include:
    • Infection
    • Metabolic dysfunction
    • Brain tumor or increased pressure on the skull
    • Exposure to toxins
    • Poor nutrition
    • No oxygen or blood flow to the brain
    Oxygen and Blood Flow to the Brain
    oxygen brain lungs
    If the flow of oxygen to the brain is disrupted, it can cause encephalopathy.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Risk factors vary. For example, alcohol abuse puts you at risk for Wernicke’s encephalopathy.

    Symptoms

    Symptoms may include:
    • Sudden or progressive changes in memory
    • Inability to concentrate
    • Abnormal drowsiness
    • Progressive loss of consciousness
    • Subtle personality changes
    • Neurological symptoms:
      • Involuntary muscle twitches
      • Tremor
      • Muscle weakness
      • Seizures
    Signs that encephalopathy may be getting worse include:
    • Severe confusion
    • Disorientation
    • Drowsiness
    • Coma
    Medical care is needed right away for these symptoms.

    Diagnosis

    Your doctor will:
    • Ask about your symptoms
    • Take your medical history
    • Do a physical exam
    Tests may include:
    • Blood tests
    • Spinal tap —removal of a small amount of spinal fluid for testing
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the brain
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the brain
    • Electroencephalogram (EEG) —a test that records the brain’s activity by measuring electrical currents through the brain

    Treatment

    The doctor will try to stop or reverse the underlying condition. Treatment options include:

    Medications

    Depending on the cause, your doctor may prescribe medicines. For example, if the cause is a toxin in the body, your doctor may prescribe medicines to lower the levels of the toxin.
    Vitamins or supplements may also be given. In some cases, these may help prevent damage to the brain.

    Dietary Changes

    Your doctor may suggest changes to your diet. For example, if you have liver damage, you may need to limit how much protein you eat.
    Tube feeding and life support may be needed, especially in the case of coma.

    Surgery

    In some cases, you may need an organ transplant or dialysis. With dialysis , toxins are removed from the blood through a filtering process.

    Prevention

    Many causes cannot be prevented. Take these steps to help reduce your chance of getting encephalopathy:
    • Get early treatment for liver problems. If you have any of the above symptoms, call your doctor right away.
    • If you have a disease, see your doctor regularly.
    • Avoid overdosing on drugs, alcohol, or medicines.
    • Avoid being exposed to poisons or toxins.

    RESOURCES

    National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

    CANADIAN RESOURCES

    Canadian Liver Foundation http://www.liver.ca/

    Health Canada http://www.hc-sc.gc.ca/index-eng.php

    References

    Encephalopathy. California Pacific Medical Center website. Available at: http://www.cpmc.org/learning/documents/encephalopathy-ws.pdf . Updated May 2004. Accessed May 26, 2011.

    Encephalopathy. Congress of Neurological Surgeons website. Available at: http://wiki.cns.org/wiki/index.php/Encephalopathy . Updated July 2007. Accessed May 26, 2011.

    NINDS encephalopathy page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm . Updated November 2010. Accessed May 26, 2011.

    Smith N. Hepatic encephalopathy. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 2010. Accessed May 26, 2011.

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