Encephalopathy is condition caused by diseases that affect large portions of the brain. The disease may affect the function and/or the structure of the brain leading to a wide range of physical and mental symptoms. An altered mental state, such as confusion and sudden mood changes, is often a hallmark of encephalopathy.
There are several causes of encephalopathy. Treating the underlying disease or injury causing the encephalopathy may reverse symptoms in some. Some causes of encephalopathy may result in lasting changes in the brain. If the brain injury is severe and cannot be reversed, it can be fatal.
Encephalopathy is caused by widespread dysfunction of the brain. Some common causes include: InfectionHead trauma Metabolic dysfunction—causes an imbalance in nutrients and electrolytes the brain needs to functionBrain tumor or increased intracranial pressureExposure to toxinsPoor nutrition—causes an imbalance in nutrients and electrolytes the brain needs to functionNo oxygen or blood flow to the brainOrgan failureSeizures and post-seizure dysfunction
Oxygen and Blood Flow to the Brain
If the flow of oxygen to the brain is disrupted, it can cause encephalopathy.
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Risk factors vary depending on type of encephalopathy. For example, alcohol use disorder puts you at risk for Wernicke’s encephalopathy or hepatic encephalopathy.
An altered mental state may include: Sudden or progressive changes in memoryInability to concentrateImpaired thinkingAbnormal drowsinessMood changesProgressive loss of consciousnessSubtle personality changes
Other symptoms may include: Involuntary muscle twitches and flapping movementsTremorMuscle weakness and unsteadinessAbnormal eye movementsSeizures
Signs that encephalopathy may be getting worse include: Progressive confusionProgressive drowsinessComa
Medical care is needed right away for these symptoms.
Your doctor will ask you or your caregiver about your symptoms and medical history. A physical exam will be done.
To confirm diagnosis and determine the cause or extent of the encephalopathy, your doctor may request: Blood testsLumbar puncture—removal of a small amount of spinal fluid for testing
CT scan or MRI scanElectroencephalogram (EEG)—a test that records the brain’s electrical activity
The goal of treatment is to try to stop or reverse the damage by managing the condition causing the encephalopathy. Treatment is based on the cause, but may include: Medications—to treat infections, manage related conditions like high blood pressure, remove toxins, and replace missing or low levels of vitamins or nutrientsDietary changes—to improve nutrition or manage underlying conditionDialysis—to clear harmful substances, like toxins, out of the bloodOrgan transplant
Medical support may be needed through recovery including feeding tube or breathing support with severe encephalopathy.
Many causes cannot be prevented. To help reduce the chance of encephalopathy: Get early treatment for liver problems. If you have any of the above symptoms, call your doctor right away.If you have a disease, see your doctor regularly.Avoid overdosing on drugs, alcohol, or medications.Avoid being exposed to poisons or toxins and infections or carriers of infections, such as mosquitoes.
Cirrhosis complications: Encephalopathy. California Pacific Medical Center website. Available at:
http://www.sutterhealth.org/health/healthinfo/?section=healthinfo&page=article&sgml_id=aa81211. Updated November 14, 2014. Accessed February 12, 2016.
NINDS encephalopathy page. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm. Updated November 9, 2010. Accessed February 12, 2016.
Last reviewed February 2016 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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