WHAT YOU NEED TO KNOW: What is encephalopathy?Encephalopathy is a term used to describe brain disease or brain damage. It usually develops because of a health condition such as cirrhosis, or a brain injury. Symptoms may be mild or severe, and may be short-term or permanent. What causes or increases my risk for encephalopathy? - A brain tumor, or a brain injury, such as a concussion
- Lack of oxygen to the brain, or damage to a brain blood vessel, such as a stroke
- An infection from bacteria, viruses, or parasites
- Exposure to a chemical such as carbon monoxide, lead, or ammonia
- A chronic infection, such as HIV, herpes, or hepatitis B or C
- High or low calcium, sodium, or glucose levels, or a lack of vitamin B1
- A large amount of alcohol, use of certain medicines or drugs, or withdrawal from alcohol or drugs
- Liver or kidney failure or cancer
- A mental condition, such as severe depression
What are the signs and symptoms of encephalopathy? Signs and symptoms will depend on what is causing your encephalopathy. You may have any of the following: - Mood changes, a short attention span, and drowsiness
- Disorientation (not knowing where you are or what day it is)
- Personality changes, or getting angry easily
- Memory loss
- Movement problems, such as clumsiness, tremors, or muscle twitches or pain
How is the cause of encephalopathy diagnosed? Your healthcare provider may ask you about your symptoms and when they began. He may ask if you had a head injury or were recently sick. Tell him about all your medicines, and if you drink alcohol or use drugs. You may also need any of the following: - Blood or urine tests may be used to check for an infection or a chemical, such as lead. Your glucose, sodium, and vitamin B1 levels may also be tested. Your blood may be tested for alcohol, drugs, or medicines. Blood tests may also be used to check your liver or kidney function.
- CT or MRI pictures may show swelling, an injury, or an infection in your brain.
- An EEG may be used to check how your brain is working. Small pads or metal discs are put on your head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of your brain.
- A neurologic exam can show how well your brain works. Your healthcare provider will check how your pupils react to light. He may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
- A lumbar puncture, or spinal tap, may be used to check for an infection. Your healthcare provider will take a sample of spinal fluid to be tested.
How is encephalopathy treated? The cause of your encephalopathy will be treated, if possible. You may need any of the following: - Medicines may be given to raise or lower your blood pressure. You may also need medicine to fight an infection. Medicines may be used to increase or decrease the amount of glucose in your blood. You may also need a vitamin B supplement if the amount in your blood is too low.
- Liquids may be given through your IV to increase your blood pressure.
- Extra oxygen may be given if your oxygen level is too low.
- Artificial liver support may be needed. A machine is used to clean your blood when your liver cannot. Chemicals and waste products are removed from your blood by a filtering machine. Your blood is passed through a filter and then returned to your body.
- Surgery to correct blood flow to the liver, or a liver transplant may be needed.
What can I do to manage encephalopathy? - Limit or do not drink alcohol. Alcohol can worsen your condition. Alcohol can also cause new or worsening damage to your liver and brain. Ask your healthcare provider if it is safe for you to drink alcohol. Limit alcohol to 1 drink a day if you are a woman, or 2 drinks a day if you are a man. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
- Eat low-protein and low-sodium foods, if directed. If your symptoms are caused by a liver disease, you may be asked to eat less protein and sodium (salt). Some foods high in protein include beef, pork, poultry (chicken, turkey), beans, and nuts. Some foods high in sodium include salty snacks, canned foods, condiments, deli meats, and cured meat such as bacon. Ask your dietitian for more information about foods to limit or avoid.
Call 911 or have someone else call for any of the following: - You cannot be woken.
- You had a seizure.
When should I seek immediate care? - You feel confused, dizzy, or lightheaded.
- Your heart is beating faster than is normal for you.
- You have sudden shortness of breath.
When should I contact my healthcare provider? - You have a fever.
- You are sleeping more than usual.
- You have questions or concerns about your condition or care.
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