Orginal Publication Date
MCV/Q, Medical College of Virginia Quarterly
Severe parenchymatous diseases of the liver, both acute and chronic, are frequently associated with hepatic encephalopathy. This term is preferable to that of hepatic coma, as it encompasses the whole spectrum of changes from bizarre alterations of behavior to various degrees of disturbance of consciousness, as well as protean neurologic manifestations. In many instances it is a reversible phenomenon, occurring either spontaneously or as the result of various therapeutic agents. The puzzling feature of hepatic encephalopathy is the discrepancy between dramatic clinical features and paucity of histopathological changes in the brain. The only histological changes encountered with regularity in patients with this entity are diffusely swollen and enlarged astrocytes (Adams and Foley, 1953). With no macroscopic or microscopic changes to account for cerebral dysfunction, it is likely that hepatic encephalopathy is caused by profound, yet undefined metabolic abnormalities.
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