Abstract
Hepatic encephalopathy (HE) is a serious complication of cirrhosis characterized by multiple neuropsychiatric manifestations. HE is usually triggered by a precipitating factor or in patients with severe liver disease. The main pathophysiological mechanism is the increase in blood ammonia with an alteration of the permeability of the blood brain barrier and its metabolism to glutamine in astrocytes. The diagnosis is clinical and neuroimaging techniques can be complementary. The clinical assessment should be directed to identify the trigger. Non-absorbable disaccharides and rifaximin are the treatment of choice.
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