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Revista Ecuatoriana de Neurología

On-line version ISSN 2631-2581Print version ISSN 1019-8113


MORCILLO-MUNOZ, Andrés Felipe; MORCILLO-MUNOZ, Jorge Alfredo; RODRIGUEZ-PANTOJA, David Alejandro  and  OTERO-REGINO, William. Hepatic Encephalopathy: Diagnosis And Treatment In 2019. Rev Ecuat Neurol [online]. 2020, vol.29, n.1, pp.104-114. ISSN 2631-2581.

Hepatic encephalopathy is a clinical syndrome of neuropsychiatric disturbances secondary to the variable combination of hepatocellular dysfunction and portal hypertension. It is an ominous entity, which marks a high risk of death in patients with cirrhosis, since its appearance occurs in advanced stages of it. The spectrum of manifestations ranges from subclinical EH, which is only diagnosed by alterations in neuro-psychometric tests, to coma. Currently, the treatment has ammonium as a therapeutic target, either inhibiting or decreasing its production or modifying its extraction and the two most important complications are rifaximin and lactulose, which have proven efficacy both in the management of the acute episode and in preventing recurrence. In 90% of patients, a precipitating factor can be identified and makes part of the entity's management treat that factor. Despite its wide recommendation, there are recommendations that lack enough evidence to be implemented. As with other complications of portal hypertension, hepatic encephalopathy is an indication of liver transplantation.

Keywords : encephalopathy; lactulose; rifaximin; cirrhosis.

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