A neuropsychiatric syndrome caused by disease of the LIVER, and occurring most often in patients with CIRRHOSIS – see also LIVER, DISEASES OF; it also occurs in acute form in acute failure of liver function. The disorder is believed to be the result of biochemical disturbance of brain function, because the condition is reversible and pathological changes in brain tissue are rarely found. The patient’s intellect, personality, emotions and consciousness are altered but neurological signs may or may not be identiﬁed. Apathy, confusion, drowsiness, sometimes CONVULSIONS, speech disturbance and eventually COMA mark the progress of the condition. The principles of treatment are to remove the precipitating causes. These include: URAEMIA; sedative, antidepressant and hypnotic drugs; gastrointestinal bleeding; too much protein in the diet; infection; and trauma (including surgical operations).
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