The face of hepatic encephalopathy(HE) is changing.This review explores how this neurocognitive disorder,which is associated with both acute and chronic liver injury,has grown to become a dynamic syndrome that spans a...The face of hepatic encephalopathy(HE) is changing.This review explores how this neurocognitive disorder,which is associated with both acute and chronic liver injury,has grown to become a dynamic syndrome that spans a spectrum of neuropsychological impairment,from normal performance to coma.The central role of ammonia in the pathogenesis of HE remains incontrovertible.However,over the past 10 years,the HE community has begun to characterise the key roles of inflammation,infection,and oxidative/nitrosative stress in modulating the pathophysiological effects of ammonia on the astrocyte.This review explores the current thoughts and evidence base in this area and discusses the potential role of existing and novel therapies that might abrogate the oxidative and nitrosative stresses inflicted on the brain in patients with,or at risk of developing,HE.展开更多
Hepatic encephalopathy is a medical phenomenon that is described as a neuropsychiatric manifestation of chronic or acute liver disease that is characterized by psychomotor,intellectual and cognitive abnormalities with...Hepatic encephalopathy is a medical phenomenon that is described as a neuropsychiatric manifestation of chronic or acute liver disease that is characterized by psychomotor,intellectual and cognitive abnormalities with emotional/affective and behavioral disturbances.This article focuses on the underlying mechanisms of the condition and the differences between hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy.Hepatic encephalopathy is a serious condition that can cause neurological death with brain edema and intracranial hypertension.It is assumed that approximately 60%-80% of patients with liver cirrhosis develop hepatic encephalopathy This review explores the complex mechanisms that lead to hepatic encephalopathy.However,noncirrhotic hyperammonemic encephalopathy is not associated with hepatic diseases and has a completely different etiology.Noncirrhotic hyperammonemic encephalopathy is a severe occurrence that is connected with multiple pathogeneses.展开更多
基金Supported by A5 year UK Department of Health HEFCE Clinical Senior Lectureship (to Dr.Shawcross DL)
文摘The face of hepatic encephalopathy(HE) is changing.This review explores how this neurocognitive disorder,which is associated with both acute and chronic liver injury,has grown to become a dynamic syndrome that spans a spectrum of neuropsychological impairment,from normal performance to coma.The central role of ammonia in the pathogenesis of HE remains incontrovertible.However,over the past 10 years,the HE community has begun to characterise the key roles of inflammation,infection,and oxidative/nitrosative stress in modulating the pathophysiological effects of ammonia on the astrocyte.This review explores the current thoughts and evidence base in this area and discusses the potential role of existing and novel therapies that might abrogate the oxidative and nitrosative stresses inflicted on the brain in patients with,or at risk of developing,HE.
文摘Hepatic encephalopathy is a medical phenomenon that is described as a neuropsychiatric manifestation of chronic or acute liver disease that is characterized by psychomotor,intellectual and cognitive abnormalities with emotional/affective and behavioral disturbances.This article focuses on the underlying mechanisms of the condition and the differences between hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy.Hepatic encephalopathy is a serious condition that can cause neurological death with brain edema and intracranial hypertension.It is assumed that approximately 60%-80% of patients with liver cirrhosis develop hepatic encephalopathy This review explores the complex mechanisms that lead to hepatic encephalopathy.However,noncirrhotic hyperammonemic encephalopathy is not associated with hepatic diseases and has a completely different etiology.Noncirrhotic hyperammonemic encephalopathy is a severe occurrence that is connected with multiple pathogeneses.
