What is hepatic encephalopathy?

Combination of acute hepatic failure, chronic hepatic failure or porto-systemic shunting could lead to complex neuropsychiatric syndrome Precipitated by (uremia, GI bleed, dehydration, constipation, infection, metabolic alkalosis, hypokalemia, excessive dietary protein, sedatives, hypoxia, hypoglycemia, hypothyroid, anemia) Dx (clinical dx, poor correlation w/ ammonia levels, psychometric testing and EEG (only used in research)) Tx (Identify precipitating factors and correct, protein restriction 30-40 g/day, non absorbable disaccharides, non absorbed oral Abx like neomycin/ rifamixin.