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World J Gastroenterol. Jan 7, 2013; 19(1): 26-34
Published online Jan 7, 2013. doi: 10.3748/wjg.v19.i1.26
Current pathogenetic aspects of hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy
Halina Cichoż-Lach, Agata Michalak
Halina Cichoż-Lach, Department of Gastroenterology, Medical University of Lublin, 20094 Lublin, Poland
Agata Michalak, 2nd Faculty of Medicine, Medical University of Lublin, 20059 Lublin, Poland
Author contributions: Cichoż-Lach H and Michalak A contributed equally to this work, they both made substantial contributions to the study conception and design, and the text of the paper.
Correspondence to: Halina Cichoż-Lach, Professor, Department of Gastroenterology, Medical University of Lublin, Jaczewski Str. 8, 20094 Lublin, Poland. lach.halina@wp.pl
Telephone: +48-60-1377656 Fax: +48-81-4796135
Received: May 11, 2012
Revised: July 25, 2012
Accepted: July 28, 2012
Published online: January 7, 2013
Abstract

Hepatic encephalopathy is a medical phenomenon that is described as a neuropsychiatric manifestation of chronic or acute liver disease that is characterized by psychomotor, intellectual and cognitive abnormalities with emotional/affective and behavioral disturbances. This article focuses on the underlying mechanisms of the condition and the differences between hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy. Hepatic encephalopathy is a serious condition that can cause neurological death with brain edema and intracranial hypertension. It is assumed that approximately 60%-80% of patients with liver cirrhosis develop hepatic encephalopathy. This review explores the complex mechanisms that lead to hepatic encephalopathy. However, noncirrhotic hyperammonemic encephalopathy is not associated with hepatic diseases and has a completely different etiology. Noncirrhotic hyperammonemic encephalopathy is a severe occurrence that is connected with multiple pathogeneses.

Keywords: Hepatic encephalopathy; Noncirrhotic hyperammonemic encephalopathy; Pathogeneses; Ammonia; Astrocyte; Oxidative stress