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Encephalopathy

Encephalopathy

The term "encephalopathy" refers to illness or injury to the brain. It occurs whenever there is a shift in how your brain functions or when your body undergoes a change that has an impact on your brain. These modifications result in a changed state of mind, which is occasionally accompanied by physical symptoms (for example, poor coordination of limb movements).

In most instances, the term "encephalopathy" is followed by a number of phrases that define the cause, origin, or unique characteristics of the patient that result in brain dysfunction. For instance, hepatic encephalopathy denotes brain dysfunction brought on by liver illness, whereas anoxic encephalopathy denotes brain damage brought on by a lack of oxygen.

Moreover, other terms either describe bodily ailments or syndromes of brain abnormalities. Wernicke's encephalopathy (also known as Wernicke's syndrome) and metabolic encephalopathy are two examples of this. 

Types:

Encephalopathy has two main types:

  1. Irreversible: The physical damage to the brain caused by encephalopathy, which can result from head traumas, poisons, cardiac arrest, or a lack of oxygen, is typically irreversible. That implies that your mental state might not return to how it was.
  2. Reversible: In cases with reversible encephalopathies, such as those brought on by infections, metabolic disorders, or organ failure, symptoms typically disappear after the underlying cause is addressed, and you may be able to return to your prior level of mental functioning. 

Symptoms:

Your encephalopathy's kind and the cause will determine your symptoms; however, some of the more typical ones include:

  • Confusion
  • Memory loss
  • Behavioural shifts
  • Having trouble focusing or thinking clearly

Some individuals may also:

  • Difficulty speaking
  • Muscle weakness or uncontrollable twitches
  • They have uncontrollable eye movements.
  • Tremors
  • difficulty swallowing
  • Sleepiness
  • Seizures

Call your doctor or visit the emergency department if you or anyone else exhibits any of these symptoms.

Diagnosis:

Encephalopathy is often diagnosed by clinical tests performed during a physical examination (mental status tests, memory tests, and coordination tests) that demonstrate an altered mental state. Some common diagnostic tests are:

  • Complete blood count or CBC  to check for infections or blood loss
  • Blood pressure to check if the blood pressure is abnormally high or low
  • Metabolic tests are done to determine levels of electrolytes, glucose, lactate, ammonia, oxygen, and liver enzymes in the blood
  • Drugs or toxin levels for alcohol, cocaine, amphetamines, and many others
  • Kidney function tests
  • CT and MRI scan to look for any brain swelling, anatomical abnormalities, or infections.
  • Doppler ultrasound is done to find abnormal blood flow to tissues or abscesses
  • Encephalogram or EEG produces brain wave patterns indicating any damage or abnormality in the brain

Treatment:

Depending on the underlying cause of the symptoms, encephalopathy has different treatments. As a result, not all encephalopathy patients receive the same care.

Here are some examples of various "encephalopathy therapies" for various causes:

  • Short-term anoxia (typically lasting less than two minutes): Oxygen therapy
  • Long-term anoxia: rehabilitation
  • Alcohol toxicity in the short term: IV fluids or no therapy
  • Long-term alcohol abuse (cirrhosis or chronic liver failure): antibiotics, lactulose oral solution, low-protein diet
  • Uremic encephalopathy (related to kidney failure): Dialysis and kidney transplantation are used to treat the underlying physiologic cause
  • Diabetes encephalopathy: Treatment with glucose for hypoglycemia and insulin for hyperglycemia
  • Hypotensive or hypertensive encephalopathy: Medications that increase (in the case of hypotension) or lower (in the case of hypertension) blood pressure

Understanding the underlying cause of any encephalopathy is essential to treating it, as is developing a therapeutic strategy.

Alarming factors:

Encephalopathy is a medical condition that can have a wide range of complications, from none to severe mental disabilities that can result in death. Many researchers believe that encephalopathy is a secondary condition that arises due to an underlying medical condition or diagnosis. The complications associated with encephalopathy can vary depending on the underlying cause.

Uremic encephalopathy can cause lethargy, hallucinations, stupor, muscle twitching, seizures, and death. Hashimoto's encephalopathy can result in confusion, heat intolerance, and dementia. Wernicke's encephalopathy can cause mental confusion, memory loss, and a decreased ability to move the eyes. Bovine spongiform encephalopathy (BSE) or "mad cow disease" can lead to ataxia, dementia, and myoclonus, or muscle twitching without any rhythm or pattern. Shigella encephalopathy may cause headache, stiff neck, delirium, seizures, and coma.

Infectious causes of pediatric encephalopathy can lead to irritability, poor feeding, hypotonia (or "floppy baby syndrome"), seizures, and death. To understand the potential side effects of encephalopathy, it is important to discuss them with the diagnosing physician, who can explain the specific risks associated with the underlying cause(s) of the particular type of encephalopathy.

Conclusion:

Encephalopathy is a broad term referring to brain damage. This can be due to certain underlying health conditions or an injury to the head. There are two types of encephalopathy: reversible and irreversible. In the case of reversible encephalopathy, the brain damage and resultant mental conditions are temporary and can be regained over time with medications and rehabilitation, while the same is not true for irreversible encephalopathy, where the conditions are permanent and can only be managed to provide a better quality of life. The diagnosis and treatment procedures vary for different encephalopathies and depend on the underlying primary conditions. Therefore, these might not be the same for every person who has encephalopathy. It is highly advisable to contact a healthcare professional if you experience any symptoms. They will help you with the diagnosis and plan the treatment procedure thereafter.

 

Medanta Medical Team
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