title: [Hepatic encephalopathy].
abstract: Hepatic encephalopathy (EH) is a severe complication of hepatic cirrhosis that is characterized by multiple neuropsychiatric manifestations. EH is usually triggered by a precipitating factor and occurs in patients with severely impaired hepatic function. Minimal EH is characterized by minor cognitive impairments that are difficult to specify but represent a risk for the patients. The primary pathophysiological mechanism of EH is considered to be an increase in blood ammonia with an impairment in the patency of the blood-brainbarrier and its metabolism to glutamine in astrocytes. The diagnosis is clinical and neuroimaging techniques can be complementary. The diagnosis of minimal EH requires specific neurocognitive tests. The clinical evaluation should be directed towards identifying the trigger. Nonabsorbable disaccharides and rifaximin constitute the treatment of choice, along with prophylaxis for new episodes.
authors.affiliation: Servicio de Hepatología, Hospital Vall d'Hebron, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Córdoba
authors.affiliation: Servicio de Hepatología, Hospital Vall d'Hebron, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España. Electronic address: resteban@vhebron.net.
authors.forename: Rafael Esteban
authors.initials: RE
authors.lastname: Mur
mesh_terms: D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D012008:Recurrence
keywords: Barrera hematoencefálica; Blood-brain barrier; Encefalopatía hepática; Hepatic encephalopathy