Encephalopathy - Causes, Symptoms, Diagnosis & Treatment

Encephalopathy

Authored by Dr.Mohan Rao on 25 May 2015 - 15:28

Encephalopathy is a term used to define brain damage, disease or malfunction. The symptoms range from mild symptoms such as memory loss or slight personality changes to severe such as seizures, dementia, coma or death. Generally encephalopathy affects the mental state, but sometimes it is also accompanied by physical symptoms such as poor coordination of limb movements.

In most cases, the term encephalopathy is preceded by different terms which are used to describe the cause or the medical condition which is responsible for the brain malfunction. Some examples include anoxic encephalopathy which means damage of brain due to insufficient oxygen supply and hepatic encephalopathy which means brain malfunction due to a liver disease.

 

 

There are many different causes of encephalopathy which includes:

  • Infectious encephalopathy caused due to bacteria, viruses or parasites
  • Anoxic encephalopathy caused due to lack of oxygen
  • Alcoholic encephalopathy caused due to alcohol toxicity
  • Hepatic encephalopathy caused due to liver disease or liver failure
  • Uremic encephalopathy caused due to renal disease or renal failure
  • Other causes include brain tumors, brain cell destruction (trauma), toxic chemicals such as mercury, lead or ammonia, alterations in brain pressure and poor nutrition.
  • Some drugs can also cause encephalopathy such as posterior reversible encephalopathy syndrome (PRES) which is caused due to cyclosporine and tacrolimus.

 

 

The symptoms of a patient depends on the severity and cause of encephalopathy

Mental symptoms:

  • Difficulty in focusing
  • Memory loss
  • Difficulty in problem solving
  • Change in personality
  • Drowsy and lethargic

Neurological changes:

  • Muscle weakness in one area
  • Poor concentration or decision making
  • Trembling
  • Involuntary twitching
  • Seizures
  • Difficulty in speaking or swallowing

 

 

To diagnose encephalopathy, the physician may first ask questions about the symptoms experienced and also takes the medical history. The physician will also perform a physical examination to check for neurological and mental symptoms.

If the physician suspects any damage in the brain, he/she may conduct the following tests to detect the severity and cause of the disease/damage:

  • Blood tests may be done to detect the presence of any bacteria, viruses, toxins or a disease.
  • Spinal tap: Sample of the cerebrospinal fluid is collected to check for bacteria, toxins, viruses or diseases.
  • Computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain may be done to detect the damage or abnormalities in the brain.
  • Electroencephalogram (EEG) test is done to measure the electrical activity of the brain.

 

 

 

The treatment of encephalopathy depends on the primary cause of the symptoms. Some examples of different treatments used for various causes of encephalopathy are as follows:

  • Short term anoxia (less than two minutes): Oxygen therapy.
  • Long term anoxia: Rehabilitation
  • Short term alcohol toxicity: Intra-venous fluids or no therapy
  • Long term alcohol abuse (chronic liver failure or cirrhosis): Low protein diet, oral lactulose, antibiotics
  • Uremic encephalopathy (kidney failure): Correction of the underlying physiologic cause, kidney transplant, dialysis
  • Diabetic encephalopathy: Glucose is administered to treat hypoglycemia, insulin for treating hyperglycemia
  • Hypotensive or hypertensive encephalopathy: Drugs to increase or decrease the blood pressure

The principle for treating any kind of encephalopathy is to first determine the underlying cause and then design the treatment regime to reduce or eliminate the cause. Static encephalopathy is a type of encephalopathy which is difficult or impossible to treat as the brain damage or altered mental state is permanent. It’s only possible to prevent further damage and also implement rehabilitation to help the patient perform at his/her highest possible function level.

 

 

Types of encephalopathy which are hereditary are not preventable. Some of the types are preventable. Maintaining a healthy lifestyle can help reduce the risk factors of brain damage. Following are some changes in life which can help to lessen the risk of many causes of encephalopathy:

  • Avoid excess alcohol consumption
  • Eat a healthy diet
  • Avoid exposure to harmful substances like drugs
  • Visit you physician regularly

 

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.