G.S. GALYAUTDINOV, A.A. DANILIN

Kazan State Medical University, Kazan

Contact details:

Galyautdinov G.S. — MD, Professor of the Department of Hospital Therapy

Address: 49 Butlerov St., 420012 Kazan, Russian Federation, tel.: +7-960-048-37-63, e-mail: genschat.galyautdinov@kazangmu.ru

The article presents a modern view on hepatic encephalopathy — a potentially reversible syndrome of complex dysfunction of the brain in patients with progressive liver failure. The main aspects of classification, etiology, epidemiology and pathogenesis, clinical presentation, diagnostics and treatment of hepatic encephalopathy are covered. The prevalence of hepatic encephalopathy is increasing and, according to forecasts, will become a more urgent health problem. There are three types of hepatic encephalopathy depending on the underlying disease and five pathogenetic theories of the pathological condition (theories of «glia», neurotransmission disorders, bile acids, metals, and neuronal necrosis). The clinical picture is extremely heterogeneous. The main diagnostic methods are neuropsychiatric, neurophysiological, and neuroimaging. Treatment is aimed at eliminating the underlying cause of the condition, as well as reducing the production and absorption of ammonia: a specific diet, the use of lactulose, rifaximin, flumazenil.

Key words: hepatic encephalopathy, neurotoxicity, liver cirrhosis, gastroenterology.

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