ABSTRACT
Hepatic encephalopathy is a neuropsychiatric syndrome that refers to potentially reversible derangement of thought and behavior which accompany liver disease.1 Although there may be significant overlap in symptoms and etiology, both liver disease and hepatic encephalopathy can exist in either acute or chronic forms. Although chronic hepatic encephalopathy is more prevalent, the neurologic changes accompanying acute liver failure are more dramatic and may develop rapidly. Clinically, the management of these two entities can be quite distinct. Fulminant hepatic failure (FHF) is a true medical emergency and the onset of encephalopathy is both a defining symptom and a major prognostic indi cator.2 Without appropriate and timely intervention, the underlying neuropathology o f this condition can lead directly to the patient’s death. In the past decade, survival o f FHF patients improved significantly due, in part, to enhanced ability to manage the cerebral manifestations of the disease.2 This section will focus on the prevailing theories regarding the pathophysiology of the syndrome and will discuss the details regarding diagnosis and monitoring methods currently available.
