Description Confusion, agitatio...
Description
Confusion, agitation, and abnormal arm and leg movements caused by liver failure (cirrhosis). The disease is caused by the buildup of toxic substances that are normally cleared by the liver, such as ammonia. The disorder is triggered by dehydration, eating too much protein, bleeding from the intestinal tract, infections, kidney failure, low oxygen levels, shunt placement or surgery.
Symptoms
Symptoms occur gradually and include confusion, change in behavior, personality changes, agitation, sleeping problems, abnormal movements of the arms and legs, seizures, slurred speech, and coma.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be done. A brain CT scan and/or MRI may be performed to rule out other causes of the symptoms. Blood tests including an ammonia level will also be done.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP)
Specialists:
Gastroenterology, Internal Medicine, Pediatrics, Family Practice, Pediatric Gastroenterology
Workup:
A history and physical exam will be done. A brain CT scan and/or MRI may be performed to rule out other causes of the symptoms. Blood tests including an ammonia level will also be done.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP)
Specialists:
Gastroenterology, Internal Medicine, Pediatrics, Family Practice, Pediatric Gastroenterology
Treatment
Therapy is aimed at treating the triggering event as well as the hepatic encephalopathy. Patients should avoid eating high protein foods. Treatment includes causing diarrhea with medications such as lactulose and giving antibiotics orally such as neomycin. These treatments remove ammonia from the large intestine, and from the body.