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Previous Volume 337:473-479 August 14, 1997 Number 7 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Hepatic encephalopathy is a complex neuropsychiatric syndrome that may occur in such diverse clinical situations as inherited errors of the urea cycle, acute or chronic liver disease, and spontaneous or iatrogenic portosystemic venous shunting, including that following procedures to establish a transjugular intrahepatic portosystemic shunt. The clinical manifestations of this syndrome range from subtle abnormalities detectable only by psychometric testing to deep coma. Several grading systems have been proposed; one based on clinical and electroencephalographic abnormalities is shown in Table 1.¹ Hepatic encephalopathy may be present in 50 to 70 percent of all patients with cirrhosis, including those with . . . [Full Text of this Article]

Approach to Management

Reduction of Production and Absorption of Ammonia

Increased Metabolism of Ammonia in the Tissues

Reduction of False Neurotransmitters

Inhibition of -Aminobutyric Acid–Benzodiazepine Receptors

Correction of Manganese Deposition in the Basal Ganglia

Orthotopic Liver Transplantation

Source Information

From the Institute of Hepatology, University College London Medical School, 69–75 Chenies Mews, London WC1E 6HX, United Kingdom, where reprint requests should be addressed to Dr. Williams.

References

Related Letters:

Management of Hepatic Encephalopathy
Plauth M., Merli M., Kondrup J., Riordan S. M., Williams R.
Extract | Full Text  
N Engl J Med 1997; 337:1921-1922, Dec 25, 1997. Correspondence

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