Hepatic encephalopathy is a disorder in the brain that is the result of severe liver problems. It is most often seen in those individuals who suffer from cirrhosis caused by drinking excessive amounts over and extended period of time. The disease itself manifests by decreasing the amount of functioning liver cells; as this happens, the blood normally circulated via the liver is diverted, causing the blood which would normally be ‘filtered’ for toxins courses through the body, unchecked. This ‘unfiltered’ blood, in the alcoholic patient, may very well contain toxins which are extremely detrimental to the functions of the brain. The most detrimental and aggravating toxins are ammonia and manganese.
When this ‘bypass’ of blood product occurs, and toxic blood is used throughout the system, the damage to the organs especially, begins almost immediately. Because the body is not capable of breaking down the ammonia level by itself, it (the ammonia) will begin to infiltrate into the system, eventually into the brain. This is when the symptoms may begin to appear.
Early Hepatic Encephalopathy Symptoms
With an excess of ammonia in the body, the central nervous system will try to incorporate it into circulation. When this happens, the individual will at first appear slightly disoriented; forgetting where they placed things, or what they were doing. The symptoms will resemble those of a patient in the early stages of dementia. Soon, they will forget what they were saying, unable to complete their sentences or what they were writing. Often, they will start to sound as if they have been drinking alcohol; slurring words, mumbling incoherently and stuttering. Motor control skills are compromised and simple tasks like holding a pen, typing, or using any type of tool that requires dexterity will become difficult, if not impossible.
Depending on the level of the ammonia, the patient may exhibit a slanted, or sideways, gait when they walk. Patients report feeling as though they are walking on a tilted surface, as one would experience in a ‘fun house’. Although this perception of slanted ground beneath their feet is totally perceived by their brain, the patient is not aware that they are walking strangely, or carrying their body in a strange position. If the condition is not quickly controlled, the patient may have to be confined to a wheelchair. This is for their own protection, as they are apt to fall while attempting to correct the perceived ground level. Shaking is also a very common side effect. Trembling hands and fingers, and the inability to hold the hand in a fixed position are typical.
Late Hepatic Encephalopathy Symptoms
Eventually, a total loss of all motor skills results and dexterity is lost. The patient will take on a jaundiced appearance, noticed first in the whites of the eyes. The skin tone will follow, fading into a pallid, yellowish tint. The lips are extremely dry and begin to peel. The mouth will be constantly dry and the tongue may swell, which contributes to the slurring. If an individual experiences any of these hepatic encephalopathy symptoms, it is recommended that a physician be consulted immediately.