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Abstract Details
Clinical management of type C hepatic encephalopathy
Ridola L1, Riggio O1, Gioia S1, Faccioli J1, Nardelli S1. United European Gastroenterol J. 2020 Feb 26:2050640620909675. doi: 10.1177/2050640620909675. [Epub ahead of print]
Author information
1 Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Abstract
Type-C hepatic encephalopathy is a complex neurological syndrome, characteristic of patients with liver disease, causing a wide and complex spectrum of nonspecific neurological and psychiatric manifestations, ranging from a subclinical entity, minimal hepatic encephalopathy, to a deep form in which a complete alteration of consciousness can be observed: overt hepatic encephalopathy. Overt hepatic encephalopathy occurs in 30-40% of patients. According to the time course, hepatic encephalopathy is subdivided into episodic, recurrent and persistent. Diagnostic strategies range from simple clinical scales to more complex psychometric and neurophysiological tools. Therapeutic options may vary between episodic hepatic encephalopathy, in which it is important to define and treat the precipitating factor and hepatic encephalopathy and secondary prophylaxis, where the standard of care is non-absorbable disaccharides and rifaximin. Grey areas and future needs remain the therapeutic approach to minimal hepatic encephalopathy and issues in the design of therapeutic studies for hepatic encephalopathy.