Concise Commentary: Staying True to Type—The Increasing Inpatient Burden of Hepatic Encephalopathy

Excerpt

Hepatic encephalopathy (HE) is a serious complication of acute and chronic liver diseases that is a consequence of impaired liver function and/or portosystemic shunting. HE can manifest as a broad spectrum of neurological and psychiatric disorders, ranging from alterations of mood and sleep patterns to neuromuscular symptoms such as asterixis and ataxia to hepatic coma. The classification of HE is based on the type of underlying liver disease: Type A—acute liver failure; Type B—portosystemic bypass/shunting without intrinsic liver disease; and Type C—chronic liver disease or cirrhosis. HE is also classified based on the severity of its manifestations (overt vs. minimal HE), its time course, and on the presence of any precipitating factors [1]. The development of overt neurological complications is associated with a poor prognosis, often signifying hepatic decompensation and the need for liver transplantation [2, 3]. …