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Optimal brain function requires a stable metabolic environment. Extracerebral systems provide the necessary nutrients, remove metabolic products, and protect the brain from sudden metabolic perturbations. It is not surprising, therefore, that conditions such as liver or kidney failure, the ingestion of toxic substances, or the presence of inherited or acquired metabolic disorders frequently results in brain dysfunction and encephalopathy. Arieff and Griggs (an internist and neurologist, respectively), both of whom have a longstanding interest in disorders of the nervous system, have invited an international group of specialists to contribute chapters as an aid to physicians from both internal medicine and
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