Hepatic Coma or Hepatic Encephalopathy (HE)
Hepatic Coma or Hepatic Encephalopathy (HE) Definition: Hepatic encephalopathy is a neuropsychiatric syndrome caused by liver dysfunction, leading to the accumulation of toxins (especially ammonia) in the blood, which can impair brain function. In severe cases, it can progress to hepatic coma. Causes: HE typically occurs in individuals with advanced liver disease, especially cirrhosis or acute liver failure . Triggers that exacerbate the condition include: Gastrointestinal bleeding Infection Electrolyte imbalance (especially low potassium) High protein intake Constipation Dehydration Certain medications (e.g., sedatives or diuretics) Pathophysiology: The liver usually detoxifies ammonia (NH₃) by converting it into urea, which is excreted in urine. In liver failure, ammonia builds up in the bloodstream and crosses the blood-brain barrier, leading to neurological impairment. Other toxins, inflammatory mediators, and metabolic disturbances contribute to the development of encephalopa