Encephalopathy - Wikipedia, the free encyclopedia http://en.wikipedia.

org/wiki/Encephalopathy

From Wikipedia, the free encyclopedia

Encephalopathy /ɛnˌsɛfəˈlɒpəθi/ literally means disorder or Encephalopathy

disease of the brain. [1] In modern usage, encephalopathy
does not refer to a single disease, but rather to a syndrome of
global brain dysfunction; this syndrome can be caused by
many different illnesses.
Classification and external resources
MeSH D001927 (http://www.nlm.nih.gov
/cgi/mesh/2009/MB_cgi?field=uid&
term=D001927)

1 Terminology
2 Types
3 Causes
4 Diagnosis
5 Therapy
6 Prognosis
7 References
8 See also

In some contexts it refers to permanent (or degenerative)[2] brain injury, and in others it is reversible. It can be
due to direct injury to the brain, or illness remote from the brain. In medical jargon it can refer to a wide variety
of brain disorders with very different etiologies, prognoses and implications. For example, prion diseases, all of
which cause transmissible spongiform encephalopathies, are invariably fatal and have an infectious origin, but
other encephalopathies are reversible and can be caused by nutritional deficiencies, toxins, and several other
causes.

There are many types of encephalopathy. Some examples include:

Mitochondrial encephalopathy - Metabolic disorder caused by dysfunction of mitochondrial DNA. Can

affect many body systems, particularly the brain and nervous system.
Glycine encephalopathy - A pediatric metabolic disorder
Hepatic encephalopathy - Arising from advanced cirrhosis of the liver
Hypoxic ischemic encephalopathy - Permanent or transitory encephalopathy arising from severely
reduced oxygen delivery to the brain
Static encephalopathy - Unchanging, or permanent, brain damage
Uremic encephalopathy - Arising from high levels of toxins normally cleared by the kidneys -- rare where
dialysis is readily available
Wernicke's encephalopathy - Arising from thiamine deficiency, usually in the setting of alcoholism

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Hashimoto's encephalopathy - Arising from an auto-immune disorder

Hypertensive encephalopathy - Arising from acutely increased blood pressure
Lyme encephalopathy - Arising from the Borrelia Burgdorferi bacteria.
Toxic encephalopathy - A form of encephalopathy caused by chemicals, often resulting in permanent
brain damage
Toxic-Metabolic encephalopathy - A catch-all for brain dysfunction caused by infection, organ failure, or
intoxication
Transmissible spongiform encephalopathy - A collection of diseases all caused by prions, and
characterized by "spongy" brain tissue (riddled with holes), impaired locomotion or coordination, and a 40
out of 40 fatality rate. Includes bovine spongiform encephalopathy (mad cow disease), scrapie, and kuru
among others.

Encephalopathy alters brain function and/or structure. It may be caused by an infectious agent (bacteria, virus,
or prion), metabolic or mitochondrial dysfunction, brain tumor or increased intracranial pressure, exposure to
toxins (including solvents, excess animal protein, drugs, alcohol, paints, industrial chemicals, and certain
metals), radiation, trauma, poor nutrition, or lack of oxygen or blood flow to the brain.

The hallmark of encephalopathy is an altered mental state. Depending on the type and severity of
encephalopathy, common neurological symptoms are loss of cognitive function, subtle personality changes,
inability to concentrate, lethargy, and depressed consciousness. Other neurological signs may include myoclonus
(involuntary twitching of a muscle or group of muscles), asterixis (abrupt loss of muscle tone, quickly restored),
nystagmus (rapid, involuntary eye movement), tremor, seizures, jactitation (restless picking at things
characteristic of severe infection), and respiratory abnormalities such as Cheyne-Stokes respiration (cyclic
waxing and waning of tidal volume), apneustic respirations, and post-hypercapnic apnea.

Blood tests, spinal fluid examination by lumbar puncture, imaging studies, electroencephalograms and similar
diagnostic studies may be used to differentiate the various causes of encephalopathy.

Diagnosis is frequently clinical. That is, no set of tests give the diagnosis, but the entire presentation of the
illness with nonspecific test results informs the experienced clinician of the diagnosis...

Treatment varies according to the type and severity of the encephalopathy. Anticonvulsants may be prescribed
to reduce or halt any seizures. Changes to diet and nutritional supplements may help some patients. In severe
cases, dialysis or organ replacement surgery may be needed.

Treating the underlying cause of the disorder may improve or reverse symptoms. However, in some cases, the
encephalopathy may cause permanent structural changes and irreversible damage to the brain. Some
encephalopathies can be fatal.

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Encephalopathy - Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Encephalopathy

1. ^ "eMedicine/Stedman Medical Dictionary Lookup!" (http://www.emedicine.com

/asp/dictionary.asp?keyword=Encephalopathy) . http://www.emedicine.com
/asp/dictionary.asp?keyword=Encephalopathy. Retrieved 2008-11-30.
2. ^ encephalopathy (http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common
/dorlands/dorland/three/000035088.htm) at Dorland's Medical Dictionary

Adapted from http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm

The Diagnosis of Stupor and Coma by Plum and Posner ISBN 0195138988 remains one the of best detailed
observational references to the condition

Brain damage
Neurobiology
Neurobiological brain disorder
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Categories: Neurology | Neurotrauma | Greek loanwords

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