hepatic encephalopathy: early diagnosis in pediatric patients with cirrhosis

how to cite this article: dara n, sayyari aa, imanzadeh f. hepatic encephalopathy: early diagnosis in pediatric patients with cirrhosis. iran j child neurol. 2014 winter; 8(1):1-11. objective as acute liver failure (alf) and chronic liver disease (cirrhosis) continue to increase in prevalence, we will see more cases of hepatic encephalopathy. primary care physician are often the first to suspect it, since they are familiar with the patient’s usual physical and mental status. this serious complication typically occurs in patients with severe comorbidities and needs multidisciplinary evaluation and care.  hepatic encephalopathy should be considered in any patient with acute liver failure and cirrhosis who presents with neuropsychiatric manifestations, decrease level of consciousness (coma), change of personality, intellectual and behavioral deterioration, speech and motor dysfunction. every cirrhotic patient may be at risk; potential precipitating factors should be addressed in regular clinic visits. the encephalopathy of liver disease may be prominent, or can be present in subtle forms, such as decline of school performance, emotional outbursts, or depression. “subtle form” of hepatic encephalopathy may not be obvious on clinical examination, but can be detected by neurophysiologic and neuropsychiatric testing. references: ferenci p, lockwood a, mullen k, tarter r, weissenborn k, blei at. hepatic encephalopathy definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th world congresses of gastroenterology, vienna, 1998.hepatology 2002;35:716-21. bleiat,cordoba j. hepatic encephalopathy. amj gastroenterol 2001;96:1968–76. vaquero j,chung c, cahill me, bleiat. pathogenesis of hepatic encephalopathy in acute liver failure. semin liver dis 2003;23:259-69. bajaj js, wade jb, sanyal aj. spectrum of neurocognitive impairment in cirrhosis: implications for the assessment of hepatic encephalopathy. hepatology 2009; 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