Hepatic encephalopathy (liver failure confusion)
About Hepatic encephalopathy (liver failure confusion)
Confusion, agitation, and abnormal arm and leg movements caused by liver failure (cirrhosis). The disease is caused by the buildup of toxic substances that are normally cleared by the liver, such as ammonia. The disorder is triggered by dehydration, eating too much protein, bleeding from the intestinal tract, infections, kidney failure, low oxygen levels, shunt placement or surgery.Symptoms
Symptoms occur gradually and include confusion, change in behavior, personality changes, agitation, sleeping problems, abnormal movements of the arms and legs, seizures, slurred speech, and coma.Tests & Diagnostics
A history and physical exam will be done. A brain CT scan and/or MRI may be performed to rule out other causes of the symptoms. Blood tests including an ammonia level will also be done.Common tests: Complete blood count (CBC), Comprehensive metabolic panel (CMP).
OTC sleep aids and supportive treatments
Prescription medications
Conventional treatment summary
Therapy is aimed at treating the triggering event as well as the hepatic encephalopathy. Patients should avoid eating high protein foods. Treatment includes causing diarrhea with medications such as lactulose and giving antibiotics orally such as neomycin. These treatments remove ammonia from the large intestine, and from the body.Medical specialties
Gastroenterology · Internal Medicine · Pediatrics · Family Practice · Pediatric Gastroenterology
This page is educational content, not medical advice. Always consult a qualified clinician for diagnosis and treatment of Hepatic encephalopathy (liver failure confusion).