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Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology. Two forms are recognised, acute and chronic (cirrhosis). [1] Recently, a third form of liver failure known as acute-on-chronic liver failure (ACLF) is increasingly being recognized. [2]
One scheme defines "acute hepatic failure" as the development of encephalopathy within 26 weeks of the onset of any hepatic symptoms. This is sub-divided into "fulminant hepatic failure", which requires onset of encephalopathy within 8 weeks, and "subfulminant", which describes onset of encephalopathy after 8 weeks but before 26 weeks. [ 24 ]
Mitochondrial encephalopathy: Metabolic disorder caused by dysfunction of mitochondrial DNA. Can affect many body systems, particularly the brain and nervous system. Acute necrotizing encephalopathy, rare disease that occurs following a viral infection. Glycine encephalopathy: A genetic metabolic disorder involving excess production of glycine.
The treatment of hepatic encephalopathy depends on the suspected underlying cause (types A, B, or C) and the presence or absence of underlying causes. If encephalopathy develops in acute liver failure (type A), even in a mild form (grade 1–2), it indicates that a liver transplant may be required, and transfer to a specialist centre is advised ...
Acute end-organ damage may occur, affecting the neurological, cardiovascular, kidney, or other organ systems. Some examples of neurological damage include hypertensive encephalopathy , cerebral vascular accident / cerebral infarction , subarachnoid hemorrhage, and intracranial bleeding .
Recurrent subacute encephalopathy is the most commonly observed symptom, followed by dystonia, both of which are nearly always present. Additional observed symptoms include spasticity or cogwheel rigidity, seizures , difficulty swallowing ( dysphagia ), ataxia , slurred speech ( dysarthria ), ophthalmoplegia , opisthotonus , facial palsy ...
Classification for hepatic insufficiency. In hyperacute and acute liver failure, the clinical picture develops rapidly with progressive encephalopathy and multiorgan dysfunction such as hyperdynamic circulation, coagulopathy, acute kidney injury and respiratory insufficiency, severe metabolic alterations, and cerebral edema that can lead to brain death.
The term "hypertensive encephalopathy" was introduced by Oppenheimer and Fishberg in 1928 to describe the case of a patient with acute nephritis, severe hypertension, and cerebral symptoms. [ 6 ] In the past, the term "hypertensive encephalopathy" has been applied to a range of neurological problems occurring in hypertensive patients, such as ...