Existing in an acute form and in a chronic form and characterized by an alteration of the mental state, hepatic encephalopathy is a brain disease that occurs in the presence of liver failure .
The term liver failure indicates a serious morbid condition, which derives from a liver that is irremediably damaged and incapable of fulfilling several of its functions, such as protein synthesis or the elimination of infectious agents and toxins from the blood.
According to the experts, particular factors and circumstances contribute to favoring the appearance of hepatic encephalopathy, starting from a state of liver failure, including:
- Dehydration
- Improper intake of drugs, such as benzodiazepines, narcotics or antipsychotics
- Electrolyte and / or metabolic imbalances (hyponatremia, hypokalemia, alkalosis, etc.)
- Nitrogen overload, due for example to exaggerated protein intake, gastrointestinal bleeding or constipation
- Alcohol poisoning
- Infections, such as pneumonia, urinary tract infections, bacterial peritonitis, etc.
- Hypoxia
- Surgical interventions
The first descriptions of a possible connection between liver and mental illnesses date back to antiquity: Hippocrates of Kos (460-370 before Christ), Aulus Cornelio Celso (25 before Christ and 50 after Christ) and Galen (130 -200 after Christ) they speak several times, in their medical treatises, of patients with altered mental status and jaundice (NB: jaundice is a fairly recurrent sign of hepatic encephalopathy).
More recent descriptions with a few more details are dated between the 18th and 19th centuries : a particularly active physician, who also delineated the progressive characteristics of mental disorders associated with hepatic failure (1761), was Giovanni Battista Morgagni . Morgagni is famous throughout the world for being considered the father of pathological anatomy .
Coming to more recent times, around 1950, English professor Sheila Sherlock (1918-2001) of the Royal Postgraduate Medical School of London and her collaborators identified, among the possible factors favoring hepatic encephalopathy, metabolic imbalances (alkalosis) and l high presence of nitrogen in the intestine.
