Encephalopathy

{{DiseaseDisorder infobox | Encephalopathy is a nonspecific term describing a syndrome affecting the brain. Generally, it refers to involvement of large parts of the brain (or the whole organ), instead of identifiable changes confined to parts of the brain. Encephalopathy may refer to the clinical findings: altered mental state without focal findings; or, more generally, it may refer to the pathophysiology that causes these findings.

Types

There are many different causes of encephalopathy.

An example is hepatic encephalopathy, which occurs in severe cirrhosis of the liver.
A form of encephalopathy that has recently received a lot of coverage is bovine spongiform encephalopathy (BSE, "mad cow disease").
Hypertensive encephalopathy is related to intracranial hypertension

Symptoms and causes

Encephalopathy alters brain function and/or structure. It may be caused by an infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor or increased intracranial pressure, prolonged exposure to toxic elements (including solvents, drugs, radiation, paints, industrial chemicals, and certain metals), chronic progressive trauma, poor nutrition, or lack of oxygen or blood flow to the brain.

The hallmark of encephalopathy is an altered mental state. Depending on the type and severity of encephalopathy, common neurological symptoms are progressive loss of memory and cognitive ability, subtle personality changes, inability to concentrate, lethargy, and progressive loss of consciousness. Other neurological symptoms may include myoclonus (involuntary twitching of a muscle or group of muscles), nystagmus (rapid, involuntary eye movement), tremor, muscle atrophy and weakness, dementia, seizures, and loss of ability to swallow or speak.

Diagnosis

Blood tests, spinal fluid examination by lumbar puncture, imaging studies, electroencephalograms and similar diagnostic studies may be used to differentiate the various causes of encephalopathy.

Encephalopathy due to acute liver failure is vitally important to define because emergency liver transplantation and/or artificial liver support can save life.The diagnosis is given by low level of factors of coagubility (V), intense jaundice and brain edema. Electroencephalogram can be useful. Encephalopathy due to chronic liver failure is also easy to recognize and is frequently triggered by proteic intake or gastrointestinal bleeding.

Therapy

Treatment is symptomatic and varies, according to the type and severity of the encephalopathy. Anticonvulsants may be prescribed to reduce or halt any seizures. Changes to diet and nutritional supplements may help some patients. In severe cases, dialysis or organ replacement surgery may be needed.

Prognosis

Treating the underlying cause of the disorder may improve or reverse symptoms. However, in some cases, the encephalopathy may cause permanent structural changes and irreversible damage to the brain. Some encephalopathies can be fatal.

Reference

Adapted from http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm

Neurology | Neurotrauma